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4.3. Heterogeneity of the Iron Accumulation among PD Patients An interesting and innovative observation in our study was the observation of heterogeneity of brain iron accumulation among PD subjects (Table 3 and Figure 2). Despite the heterogeneity of iron content from imaging, all twelve PD patients exhibited very similar clinical signs at the time of diagnosis with unilateral symptoms and all presenting with bradykinesia, rigidity, and resting tremor. It is well known that patients with PD can progress differently with a multitude of clinical complications that can result in dyskinesia, motor fluctuation, gait impairment, and nonmotor complications including cognitive decline and hallucination, to name a few. We found the heterogeneity of iron accumulation in the brain of PD patients very interesting since the pattern of iron accumulation might be used in predicting the clinical outcome Quinapyramine of the disease. Recently Rossi et al. in a 2-year followup study of 25 patients with PD detected that the rate of iron changes was associated with individual characteristics such as cognitive decline and age at disease onset [23]. Clearly, further larger longitudinal studies are needed to test our hypothesis regarding the heterogeneity of iron accumulation and progression of the disease. To our knowledge, this study is the first study demonstrating this heterogeneity among PD patients. Limitations of the Study. The small sample size in relation to the number of statistical tests conducted click here is a limitation of this study. Nevertheless, the analysis was exploratory and results should be confirmed by additional studies. The average age of PD patients is almost 10 years older than the control subjects and age plays a significant role in brain accumulation of iron. All cases were diagnosed by at least one movement disorder specialist based on UK PD Society Brain Bank Criteria; however, there was no definitive pathological evidence to confirm our PD diagnosis. Normal brain iron varies by race/ethnicity and can be associated with environmental factors GDC-0449 cost such as diet. All patients included in the current study were de novo cases and they had not received dopaminergic therapy before the first SWI MRI. As phase can be influenced by dopaminergic therapy and disease progression, additional followup studies are needed to further elucidate these influences. 5. Conclusion Our data suggest that PD patients manifest a nonhomogeneous pattern of iron accumulation in brain, and this pattern is different among PD patients. Further studies are needed to explore whether these findings correlate with the progression of PD. To our knowledge, our study is the first to demonstrate the heterogeneity of iron accumulation among PD patients. Acknowledgments This study was supported and funded by Johnston-Teal Parkinson Endowment and Kenneth Vincent Cope Parkinson Endowment. Authors are grateful to Dr. Jack J.