Disturbance of iron metabolism as a contributing factor to SN hyperechogenicity in Parkinson's disease: implications for idiopathic and monogenetic forms.

A number of investigations have provided evidence for a central role of iron in the pathogenesis of Parkinson's disease (PD). Recently it could be demonstrated that iron related changes of the substantia nigra may be one important factor contributing to the hyperechogenicity typicall visualized by transcranial sonography in idiopathic PD. Moreover, also patients with monogenetically caused PD show this hyperechogenicity, although to a lesser extent. According to numerous findings and experiments it seems plausible that iron also contributes to the pathophysiological cascades in the monogenetic forms of PD. Therefore, it is not only essential to acknowledge the pivotal role of iron for PD, but also to enhance the effort in finding therapeutic strategies to prevent the impact of iron on neurodegenerative processes. Moreover, early detection of subjects at risk is essential for the application of therapeutic strategies at a stage at which neuroprotection is still possible.