Impact of obesity-related cerebral iron overload and perfusion alterations on cognition: A multi-parametric MRI study.
Obesity can lead to various forms of brain damage and cognitive impairments. The neuropathological mechanism may involve brain iron deposition and changes in cerebral blood flow perfusion. This study aims to use Quantitative Susceptibility Mapping (QSM) and Arterial Spin Labeling (ASL) to quantitatively assess brain iron deposition and Cerebral Blood Flow (CBF) in patients with obesity, and to explore their patterns of alteration and association with cognitive impairment. 37 patients with obesity and 45 controls underwent 3.0 T MRI and cognitive assessment. We compared susceptibility and cerebral blood flow values within automatically segmented regions of the interest and analyzed associations with cognition using partial correlations. Patients displayed increased iron in the left nucleus accumbens and bilateral red nuclei (p = 0.001, p = 0.001, p < 0.001) and abnormal perfusion in the right cerebellum, right middle frontal gyrus, left putamen, and right anterior cingulate gyrus (p < 0.001). Furthermore, iron deposition correlated with cognitive impairment. This study suggests that obese patients may exhibit iron deposition and perfusion abnormalities in certain areas of the brain. Bilateral red nuclei iron deposition is closely related to cognitive impairment. The multimodal combined application of QSM and ASL provides imaging evidence for revealing the impact of obesity on brain structure and function, and also provides potential biomarkers for targeted interventions in the future.
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