Subcortical gray matter atrophy and iron deposition in patients with vascular dementia: a multimodal MRI study.

Purpose: Vascular dementia (VAD) is the second most common type of dementia worldwide. Therefore, early detection and diagnosis, along with a clear understanding of its pathogenesis are critical for mitigating disease progression. In the present study, we aimed to elucidate the associations of brain volume and iron deposition with VAD based on structural brain and iron content analyses. Methods: Fifty-three patients with VAD and 43 control participants were recruited for this study. All participants underwent the Mini-Mental State Examination (MMSE) and brain MRI scans. This study primarily focused on the volume of specific brain regions (assessed using FreeSurfer) and iron deposition (evaluated using quantitative susceptibility mapping [QSM]). Linear regression analysis was also performed. Results: Patients with VAD exhibited significant reductions in brain volume in the left putamen (β = -0.342, 95% CI: -0.581 to -0.104), left pallidum (β = -0.099, 95% CI: -0.187 to -0.001), left hippocampus (β = -0.138, 95% CI: -0.271 to -0.004), and right hippocampus (β = -0.235, 95% CI: -0.420 to -0.051). Additionally, significant increases in iron levels were identified in the left (β = 0.006, 95% CI: 0.002 to 0.010) and right (β = 0.005, 95% CI: 0.001 to 0.009) hippocampus. Conclusions: These findings indicate that brain volume reduction and increased iron levels in specific regions may be associated with cognitive deficits in patients with VAD.