Iron-sensitive magnetic resonance imaging in Parkinson's disease: a systematic review and meta-analysis

source extracted confidence: high 2026-04-09
#humans #iron #magnetic-resonance-imaging #parkinson-disease #sensitivity-and-specificity

Iron-sensitive magnetic resonance imaging in Parkinson's disease: a systematic review and meta-analysis

Cho et al., 2021 | J Neurol | Meta Analysis

Citation

Cho Se Jin, Bae Yun Jung, ... Kim Jae Hyoung. Iron-sensitive magnetic resonance imaging in Parkinson's disease: a systematic review and meta-analysis. J Neurol. 2021-Dec;268(12):4721-4736. doi:10.1007/s00415-021-10582-x

Abstract

OBJECTIVE: To evaluate the diagnostic performance of iron-sensitive sequences targeting the substantia nigra for distinguishing patients with Parkinson's disease from control participants and to identify factors causing heterogeneity. METHODS: A systematic literature search in the Ovid-MEDLINE and EMBASE databases was performed for studies reporting the relevant topic before March 6, 2020. The pooled sensitivity and specificity values with their 95% confidence intervals were calculated using bivariate random-effects modeling. Subgroup and meta-regression analyses were also performed to determine factors influencing heterogeneity affecting the diagnostic performance among the clinical, MRI, and analytic characteristics. RESULTS: A total of 22 articles including 1126 patients with Parkinson's disease and 933 control participants were enrolled in this systematic review and meta-analysis. Of those, 12 studies used objective analyses of quantitative susceptibility measurements, and 10 visually assessed the nigrosome-1 in subjective analyses. Iron-sensitive nigral magnetic resonance imaging showed a pooled sensitivity of 92% (95% confidence interval 88-95%) and a pooled specificity of 90% (95% confidence interval 81-95%). According to subgroup and meta-regression analyses, a longer mean disease duration in patients with Parkinson's disease (≥ 5 years), subjective analysis, a smaller size of pixel (< 0.6 mm2), a larger flip angle (> 15°), a smaller slice thickness (≤ 1 mm), and specific targeting of the substantia nigra pars compacta improved the diagnostic performance. CONCLUSION: Iron-sensitive nigral magnetic resonance imaging had a favorable diagnostic performance in discriminating patients with Parkinson's disease from control participants. Subjective analytic methods remain superior to objective approaches. Further improvements of the spatial resolution and contrast-to-noise ratio to specifically target the nigrosome-1 with objective analytic methods will be needed.

Key Findings

A total of 22 articles including 1126 patients with Parkinson's disease and 933 control participants were enrolled in this systematic review and meta-analysis. Of those, 12 studies used objective analyses of quantitative susceptibility measurements, and 10 visually assessed the nigrosome-1 in subjective analyses. Iron-sensitive nigral magnetic resonance imaging showed a pooled sensitivity of 92% (95% confidence interval 88-95%) and a pooled specificity of 90% (95% confidence interval 81-95%). Ac

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population parkinson
Sample Size 1126
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Iron
  • Magnetic Resonance Imaging
  • Parkinson Disease
  • Sensitivity and Specificity
  • Substantia Nigra

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: iron

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09