ORIGINAL RESEARCH article
Front. Aging Neurosci.
Sec. Neurocognitive Aging and Behavior
Volume 17 - 2025 | doi: 10.3389/fnagi.2025.1660734
This article is part of the Research TopicIron Dysregulation, Oxidative Stress, and Inflammation: Mechanisms and Therapeutic InsightsView all articles
Regional high iron deposition is linked with cognitive impairments in peritoneal dialysis: A quantitative susceptibility mapping study
Provisionally accepted
Dashan LiYongjie YinShan JiangJiuyu YinLuyao YuNan FengZhaohua SunZilian Chen
Hongting Xu
Yu ZhouJie Fang
Xiangming Qi
Haibao Wang
Yonggui Wu*- First Affiliated Hospital of Anhui Medical University, Hefei, China
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Objective: Peritoneal dialysis (PD) patients demonstrate distinct iron homeostasis imbalances. However, the relationship between brain iron and cognitive impairment in this population remains poorly elucidated. Methods: This study enrolled 52 PD patients and 49 healthy controls (HCs). Quantitative susceptibility mapping (QSM) was employed to quantify cerebral iron deposition. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and a comprehensive neuropsychological test battery. Dose-response relationships between iron metabolism parameters and cognitive performance were analyzed using generalized additive models (GAMs). Results: PD patients exhibited significantly higher iron deposition in the left amygdala and right putamen compared to HCs. Serum ferritin (SF) demonstrated an approximately inverted U-shaped relationship with MoCA scores, with an inflection point at 258.4 μg/L (P < 0.001). Every 100 μg/L increase in SF beyond this threshold was associated with a 3.1-point decrease in MoCA score. Iron deposition in the left amygdala showed significant correlations with scores on the Digit Symbol Test (DST), Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), and Verbal Fluency Test (VFT), but exhibited no direct association with peripheral iron metabolism parameters. Conclusions: In peritoneal dialysis patients, abnormal cerebral iron deposition predominantly localizes to limbic-basal ganglia regions. Iron accumulation in the left amygdala may specifically mediate the development of multi-domain cognitive impairment. QSM represents a sensitive technique for early detection of pathological iron accumulation.
Keywords: Peritoneal Dialysis, Serum ferritin, iron deposition, cognitive impairment, Quantitative susceptibility mapping
Received: 06 Jul 2025; Accepted: 15 Sep 2025.
Copyright: © 2025 Li, Yin, Jiang, Yin, Yu, Feng, Sun, Chen, Xu, Zhou, Fang, Qi, Wang and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yonggui Wu, wuyonggui@medmail.com.cn
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