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  Brain iron content in systemic iron overload: A beta-thalassemia quantitative MRI study

Manara, R., Ponticorvo, S., Tartaglione, I., Femina, G., Elefante, A., Russo, C., et al. (2019). Brain iron content in systemic iron overload: A beta-thalassemia quantitative MRI study. NeuroImage: Clinical, 24: 102058. doi:10.1016/j.nicl.2019.102058.

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Manara, Renzo1, Author
Ponticorvo, Sara1, Author
Tartaglione, Immacolata2, Author
Femina, Gianluca1, Author
Elefante, Andrea3, Author
Russo, Camilla3, Author
Carafa, Pasquale Alessandro4, Author
Cirillo, Mario5, Author
Casale, Maddalena2, Author
Ciancio, Angela6, Author
Di Concilio, Rosanna7, Author
De Michele, Elisa8, Author
Weiskopf, Nikolaus9, Author              
Di Salle, Francesco1, 10, Author
Perrotta, Silverio2, Author
Esposito, Fabrizio1, 10, Author
1Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Baronissi, Italy, ou_persistent22              
2Department of Woman, Child and Specialist Surgery, Università della Campania “Luigi Vanvitelli”, Napoli, Italy, ou_persistent22              
3Department of Neuroradiology, University of Naples Federico II, Napoli, Italy, ou_persistent22              
4Department of Mental Health and Physics and Preventive Medicine, Università della Campania “Luigi Vanvitelli”, Napoli, Italy, ou_persistent22              
5Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Università della Campania “Luigi Vanvitelli”, Napoli, Italy, ou_persistent22              
6Hematology Operative Unit, Thalassemia Day Hospital, Hospital “Madonna delle Grazie”, Matera, Italy, ou_persistent22              
7Department of Pediatrics, Hospital “Umberto I”, Nocera Inferiore, Italy, ou_persistent22              
8Department of Transfusional Medicine, University Hospital “San Giovanni di Dio e Ruggi D'Aragona”, Scuola Medica Salernitana, Salerno, Italy, ou_persistent22              
9Department Neurophysics (Weiskopf), MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_2205649              
10Department of Diagnostic Imaging, University Hospital “San Giovanni di Dio e Ruggi D'Aragona”, Scuola Medica Salernitana, Salerno, Italy, ou_persistent22              


Free keywords: Beta-thalassemia; Brain MRI; Multi-parametric mapping; Iron; Blood transfusion
 Abstract: Objective Multisystem iron poisoning is a major concern for long-term beta-thalassemia management. Quantitative MRI-based techniques routinely show iron overload in heart, liver, endocrine glands and kidneys. However, data on the brain are conflicting and monitoring of brain iron content is still matter of debate. Methods This 3T-MRI study applied a well validated high-resolution whole-brain quantitative MRI assessment of iron content on 47 transfusion-dependent (mean-age: 36.9 ± 10.3 years, 63% females), 23 non-transfusion dependent (mean-age: 29.2 ± 11.7 years, 56% females) and 57 healthy controls (mean-age: 33.9 ± 10.8 years, 65% females). Clinical data, Wechsler Adult Intelligence Scale scores and treatment regimens were recorded. Beside whole-brain R2* analyses, regional R2*-values were extracted in putamen, globus pallidum, caudate nucleus, thalamus and red nucleus; hippocampal volumes were also determined. Results Regional analyses yielded no significant differences between patients and controls, except in those treated with deferiprone that showed lower R2*-values (p<0.05). Whole-brain analyses of R2*-maps revealed strong age-R2* correlations (r2=0.51) in both groups and clusters of significantly increased R2*-values in beta-thalassemia patients in the hippocampal formations and around the Luschka foramina; transfusion treatment was associated with additional R2* increase in dorsal thalami. Hippocampal formation R2*-values did not correlate with hippocampal volume; hippocampal volume did not differ between patients and controls. All regions with increased R2*-values shared a strict anatomical contiguity with choroid plexuses suggesting a blooming effect as the likely cause of R2* increase, in agreement with the available histopathologic literature evidence. Conclusion According to our MRI findings and the available histopathologic literature evidence, concerns about neural tissue iron overload in beta-thalassemia appear to be unjustified.


Language(s): eng - English
 Dates: 2019-10-152019-04-182019-10-232019-10-252019
 Publication Status: Published in print
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Type: Peer
 Identifiers: DOI: 10.1016/j.nicl.2019.102058
Other: Epub 2019
PMID: 31711032
PMC: PMC6849415
 Degree: -



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Project name : -
Grant ID : ORSA 181 880
Funding program : -
Funding organization : University of Salerno

Source 1

Title: NeuroImage: Clinical
Source Genre: Journal
Publ. Info: Elsevier
Pages: - Volume / Issue: 24 Sequence Number: 102058 Start / End Page: - Identifier: ISSN: 2213-1582
CoNE: https://pure.mpg.de/cone/journals/resource/2213-1582