Brain iron deposition and its association with cognition in cerebral amyloid angiopathy: a preliminary investigation

doi:10.3877/cma.j.issn.1673-9248.2025.04.004

Abstract

Abstract:

Objective

To investigate the distribution patterns of cerebral iron deposition in cerebral amyloid angiopathy (CAA) and to examine the correlation between iron deposition levels and cognitive impairment in CAA.

Methods

Patients diagnosed with CAA at the Neurology Department of Peking Union Medical College Hospital between May and November 2024 were enrolled. Quantitative susceptibility mapping (QSM) was used to noninvasively assess cerebral iron deposition. Cognitive function was evaluated using the mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA). An imaging processing workstation automatically segmented the whole brain into 106 regions of interest (ROIs), and the magnetic susceptibility values of each ROI were calculated. A univariate linear regression model was employed to analyze the correlation between magnetic susceptibility values in each brain region and cognitive scores.

Results

A total of 13 CAA patients were included, of whom 11 (84.6%) were male, with a median age of 70.0 (59.0, 74.5) years. The median MMSE score was 25 (22, 28), and the median MoCA score was 19 (14, 22). In CAA patients, magnetic susceptibility values were significantly higher in the globus pallidus [48.15 (40.50, 81.08)], putamen [36.15 (23.98, 48.98)], and caudate nucleus [27.20 (10.07, 39.85)] compared to other nuclei and cortical regions. The left putamen (β=-0.229, P=0.036) and right precuneus (β=-0.618, P= 0.045) showed significant negative correlations with MMSE scores. No significant correlation was found between regional magnetic susceptibility and MoCA scores.

Conclusion

In CAA patients, iron deposition is predominantly localized in the basal ganglia. Elevated iron deposition in the putamen and parietal lobe (precuneus) may be associated with cognitive decline in CAA.

Key words: Cerebral amyloid angiopathy, Iron deposition, Cognitive impairment, Quantitative susceptibility mapping

Shiyuan Fang, Yuhui Sha, Gan Sun, Jun Ni, Bin Peng. Brain iron deposition and its association with cognition in cerebral amyloid angiopathy: a preliminary investigation[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2025, 19(04): 284-289.

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核团	磁化率值[M（Q₁，Q₃）]	Z值	P值
苍白球	48.15（40.50，81.08）	-2.411	0.016
壳核	36.15（23.98，48.98）	-2.201	0.028
尾状核	27.20（10.07，39.85）	-2.691	0.007
丘脑	5.15（0.20，11.50）	-0.699	0.485
腹侧间脑	4.15（1.22，7.28）	-0.874	0.382
海马	2.45（-5.12，4.70）	-0.314	0.753
伏隔核	-0.60（-17.00，12.55）	-0.245	0.807
杏仁核	-1.20（-7.76，5.68）

核团	磁化率值[M（Q₁，Q₃）]	Z值	P值
苍白球	48.15（40.50，81.08）	-2.411	0.016
壳核	36.15（23.98，48.98）	-2.201	0.028
尾状核	27.20（10.07，39.85）	-2.691	0.007
丘脑	5.15（0.20，11.50）	-0.699	0.485
腹侧间脑	4.15（1.22，7.28）	-0.874	0.382
海马	2.45（-5.12，4.70）	-0.314	0.753
伏隔核	-0.60（-17.00，12.55）	-0.245	0.807
杏仁核	-1.20（-7.76，5.68）

脑区	β值	95%CI	P值	均方根误差	R²值
中央后回（右侧）	2.205	0.592~3.817	0.011	5.291	0.452
额上回（左侧）	0.937	0.372~1.500	0.004	4.800	0.549
额中回前部（左侧）	0.714	0.038~1.390	0.040	5.851	0.329
眶部（左侧）	0.722	0.117~1.328	0.024	5.601	0.385
中扣带回（右）	0.507	0.158~0.857	0.009	5.146	0.481
壳核（左侧）	-0.229	-0.441~-0.018	0.036	5.800	0.341
矩状回（右侧）	0.331	0.141~0.522	0.003	4.684	0.570
楔前叶（右侧）	-0.618	-1.219~-0.018	0.045	5.900	0.318
枕外侧回（右侧）	1.074	0.150~1.999	0.027	5.657	0.373

脑区	β值	95%CI	P值	均方根误差	R²值
中央后回（右侧）	2.205	0.592~3.817	0.011	5.291	0.452
额上回（左侧）	0.937	0.372~1.500	0.004	4.800	0.549
额中回前部（左侧）	0.714	0.038~1.390	0.040	5.851	0.329
眶部（左侧）	0.722	0.117~1.328	0.024	5.601	0.385
中扣带回（右）	0.507	0.158~0.857	0.009	5.146	0.481
壳核（左侧）	-0.229	-0.441~-0.018	0.036	5.800	0.341
矩状回（右侧）	0.331	0.141~0.522	0.003	4.684	0.570
楔前叶（右侧）	-0.618	-1.219~-0.018	0.045	5.900	0.318
枕外侧回（右侧）	1.074	0.150~1.999	0.027	5.657	0.373

脑区	β值	95%CI	P值	均方根误差	R²值
中央后回（右侧）	1.957	0.502~3.413	0.013	4.778	0.443
额上回（左侧）	0.968	0.578~1.359	<0.001	3.327	0.730
额中回前部（左侧）	0.623	0.010~1.239	0.047	5.310	0.312
眶部（左侧）	0.616	0.057~1.175	0.033	5.168	0.349
中扣带回（右侧）	0.463	0.154~0.771	0.007	4.537	0.498
矩状回（右侧）	0.295	0.122~0.468	0.003	4.235	0.562
缘上回（右侧）	0.791	0.046~1.536	0.039	5.235	0.332
枕外侧回（右侧）	1.021	0.223~1.819	0.017	4.880	0.419

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