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Chiang PL, Chen HL, Lu CH, Chen PC, Chen MH, Yang IH, Tsai NW, Lin WC. White matter damage and systemic inflammation in Parkinson's disease. BMC Neurosci 2017; 18:48. [PMID: 28595572 PMCID: PMC5465562 DOI: 10.1186/s12868-017-0367-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Accepted: 05/31/2017] [Indexed: 01/02/2023] Open
Abstract
Background Systemic inflammation and white matter (WM) alterations have been noted as effects of Parkinson’s disease (PD). This study sought to evaluate WM integrity in PD patients using diffusion tensor imaging (DTI) and to assess its relationship with systemic inflammation. Methods Sixty-six patients with PD (23 men and 43 women) and 67 healthy volunteers (29 men and 38 women) underwent blood sampling to quantify inflammatory markers and DTI scans to determine fiber integrity. The inflammatory markers included leukocyte apoptosis, as well as cellular and serum adhesion molecules, in each peripheral blood sample. DTI-related indices [including fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD)] were derived from DTI scans. The resulting FA maps were compared using voxel-based statistics to determine differences between the PD and control groups. The differences in the DTI indices, clinical severity, and inflammatory markers were correlated. Results Exploratory group-wise comparison between the two groups revealed that the PD patients exhibited extensive DTI index differences. Low FA accompanied by high RD and MD, without significant differences in AD, suggesting a demyelination process, were found in the parietal, occipital, cerebellar, and insular WM of the PD patients. The declined DTI indices were significantly correlated with increased clinical disease severity, adhesion molecules, and leukocyte apoptosis. Conclusions Patients with PD experience WM integrity damage in vulnerable regions, and these impairments are associated with increased disease severity and systemic inflammation. The possible interactions among them may represent variant neuronal injuries and their consequent processes in PD. Electronic supplementary material The online version of this article (doi:10.1186/s12868-017-0367-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pi-Ling Chiang
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305, Taiwan
| | - Hsiu-Ling Chen
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305, Taiwan
| | - Cheng-Hsien Lu
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Pei-Chin Chen
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305, Taiwan
| | - Meng-Hsiang Chen
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305, Taiwan
| | - I-Hsiao Yang
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305, Taiwan
| | - Nai-Wen Tsai
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wei-Che Lin
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung, Kaohsiung, 83305, Taiwan.
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White matter microstructure damage in tremor-dominant Parkinson's disease patients. Neuroradiology 2017; 59:691-698. [PMID: 28540401 DOI: 10.1007/s00234-017-1846-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 05/02/2017] [Indexed: 02/05/2023]
Abstract
PURPOSE Resting tremor is one of the cardinal motor features of Parkinson's disease (PD). Several lines of evidence suggest resting tremor may have different underlying pathophysiological processes from those of bradykinesia and rigidity. The current study aims to identify white matter microstructural abnormalities associated with resting tremor in PD. METHODS We recruited 60 patients with PD (30 with tremor-dominant PD and 30 with nontremor-dominant PD) and 26 normal controls. All participants underwent clinical assessment and diffusion tensor MRI. We used tract-based spatial statistics to investigate white matter integrity across the entire white matter tract skeleton. RESULTS Compared with both healthy controls and the nontremor-dominant PD patients, the tremor-dominant PD patients were characterized by increased mean diffusivity (MD) and axial diffusivity (AD) along multiple white matter tracts, mainly involving the cerebello-thalamo-cortical (CTC) pathway. The mean AD value in clusters with significant difference was correlated with resting tremor score in the tremor-dominant PD patients. There was no significant difference between the nontremor-dominant PD patients and controls. CONCLUSION Our results support the notion that resting tremor in PD is a distinct condition in which significant microstructural white matter changes exist and provide evidence for the involvement of the CTC in tremor genesis of PD.
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Imaging genetics approach to Parkinson's disease and its correlation with clinical score. Sci Rep 2017; 7:46700. [PMID: 28429747 PMCID: PMC5399369 DOI: 10.1038/srep46700] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 03/24/2017] [Indexed: 12/27/2022] Open
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disorder associated with both underlying genetic factors and neuroimaging findings. Existing neuroimaging studies related to the genome in PD have mostly focused on certain candidate genes. The aim of our study was to construct a linear regression model using both genetic and neuroimaging features to better predict clinical scores compared to conventional approaches. We obtained neuroimaging and DNA genotyping data from a research database. Connectivity analysis was applied to identify neuroimaging features that could differentiate between healthy control (HC) and PD groups. A joint analysis of genetic and imaging information known as imaging genetics was applied to investigate genetic variants. We then compared the utility of combining different genetic variants and neuroimaging features for predicting the Movement Disorder Society-sponsored unified Parkinson's disease rating scale (MDS-UPDRS) in a regression framework. The associative cortex, motor cortex, thalamus, and pallidum showed significantly different connectivity between the HC and PD groups. Imaging genetics analysis identified PARK2, PARK7, HtrA2, GIGYRF2, and SNCA as genetic variants that are significantly associated with imaging phenotypes. A linear regression model combining genetic and neuroimaging features predicted the MDS-UPDRS with lower error and higher correlation with the actual MDS-UPDRS compared to other models using only genetic or neuroimaging information alone.
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Király A, Szabó N, Párdutz Á, Tóth E, Tajti J, Csete G, Faragó P, Bodnár P, Szok D, Tuka B, Pálinkás É, Ertsey C, Vécsei L, Kincses ZT. Macro- and microstructural alterations of the subcortical structures in episodic cluster headache. Cephalalgia 2017; 38:662-673. [PMID: 28425325 DOI: 10.1177/0333102417703762] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Previous functional and structural imaging studies have revealed that subcortical structures play a key a role in pain processing. The recurring painful episodes might trigger maladaptive plasticity or alternatively degenerative processes that might be detected by MRI as changes in size or microstructure. In the current investigation, we aimed to identify the macro- and microstructural alterations of the subcortical structures in episodic cluster headache. Methods High-resolution T1-weighted and diffusion-weighted MRI images with 60 gradient directions were acquired from 22 patients with cluster headache and 94 healthy controls. Surface-based segmentation analysis was used to measure the volume of the subcortical nuclei, and mean diffusion parameters (fractional anisotropy, mean, radial and axial diffusivity) were determined for these structures. In order to understand whether the size and diffusion parameters could be investigated in a headache lateralised manner, first the asymmetry of the size and diffusion parameters of the subcortical structures was analysed. Volumes and diffusion parameters were compared between groups and correlated with the cumulative number of headache days. To account for the different size of the patient and control group, a bootstrap approach was used to investigate the stability of the findings. Results A significant lateralisation of the size (caudate, putamen and thalamus) and the diffusion parameters of the subcortical structures were found in normal controls. In cluster headache patients, the mean fractional anisotropy of the right amygdalae, the mean axial and mean diffusivity of the right caudate nucleus and the radial diffusivity of the right pallidum were higher. The mean anisotropy of the right pallidum was lower in patients. Conclusion The analysis of the pathology in the subcortical structures in episodic cluster headache reveals important features of the disease, which might allow a deeper insight into the pathomechanism of the pain processing in this headache condition.
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Affiliation(s)
- András Király
- 1 Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Nikoletta Szabó
- 1 Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.,2 International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Árpád Párdutz
- 1 Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Eszter Tóth
- 1 Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - János Tajti
- 1 Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Gergő Csete
- 1 Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Péter Faragó
- 1 Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Péter Bodnár
- 3 Department of Image Processing and Computer Graphics, Faculty of Science and Informatics, Szeged, Hungary
| | - Délia Szok
- 1 Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary
| | - Bernadett Tuka
- 1 Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.,4 MTA-SZTE Neuroscience Research Group, Szeged, Hungary
| | - Éva Pálinkás
- 5 Bacs-Kiskun County Hospital, Kecskemét, Hungary
| | - Csaba Ertsey
- 6 Department of Neurology, Semmelweis University, Budapest, Hungary
| | - László Vécsei
- 1 Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.,4 MTA-SZTE Neuroscience Research Group, Szeged, Hungary
| | - Zsigmond Tamás Kincses
- 1 Department of Neurology, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.,2 International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
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Aging of cerebral white matter. Ageing Res Rev 2017; 34:64-76. [PMID: 27865980 DOI: 10.1016/j.arr.2016.11.006] [Citation(s) in RCA: 161] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 10/21/2016] [Accepted: 11/04/2016] [Indexed: 12/12/2022]
Abstract
White matter (WM) occupies a large volume of the human cerebrum and is mainly composed of myelinated axons and myelin-producing glial cells. The myelinated axons within WM are the structural foundation for efficient neurotransmission between cortical and subcortical areas. Similar to neuron-enriched gray matter areas, WM undergoes a series of changes during the process of aging. WM malfunction can induce serious neurobehavioral and cognitive impairments. Thus, age-related changes in WM may contribute to the functional decline observed in the elderly. In addition, aged WM becomes more susceptible to neurological disorders, such as stroke, traumatic brain injury (TBI), and neurodegeneration. In this review, we summarize the structural and functional alterations of WM in natural aging and speculate on the underlying mechanisms. We also discuss how age-related WM changes influence the progression of various brain disorders, including ischemic and hemorrhagic stroke, TBI, Alzheimer's disease, and Parkinson's disease. Although the physiology of WM is still poorly understood relative to gray matter, WM is a rational therapeutic target for a number of neurological and psychiatric conditions.
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Rahmani F, Aarabi MH. Does apolipoprotein A1 predict microstructural changes in subgenual cingulum in early Parkinson? J Neurol 2017; 264:684-693. [PMID: 28168521 DOI: 10.1007/s00415-017-8403-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 01/18/2017] [Accepted: 01/20/2017] [Indexed: 01/17/2023]
Abstract
Higher plasma cholesterol levels are associated with lower Parkinson's disease (PD) risk. Apolipoprotein A-1 (ApoA-1) is a surface marker of brain HDL-like particles associated with the time of PD onset. Clinical correlates of serum Apolipoprotein A1 levels with structural brain connectivity in PD-related disorders remains unclear. Here, we applied a novel diffusion-weighted imaging approach [Diffusion Magnetic Resonance Imaging (MRI) Connectometry] to explore the association between ApoA-1 and structural brain connectivity in PD. Participants involved in this research were recruited from Parkinson's Progression Markers Initiative (PPMI). Diffusion MRI connectometry was conducted using a multiple regression against apoA-1 for 36 patients with DTI measurements available in the baseline visit. Fiber results of the connectometry were then reconstructed for each patient, and diffusion parameters were extracted and regressed against apoA-1 levels. Connectometry results revealed the subgenual cingulum to be associated with ApoA-1, with different FDR yields. This result was further supported by significant negative correlation of Quantitative Anisotropic (QA) of left subgenual cingulum (Pearson's coefficient = -0.398, p = 0.020) and Generalized Fractional Anisotropic (GFA) of right subgenual cingulum (Pearson's coefficient -0.457, p = 0.007) with plasma apoA-1 levels, in a multiple regression model with age and sex. The subgenual cingulum encompasses fibers from the anterior cingulate cortex and anterior thalamus. These structures are involved in PD-associated psychosis and executive cognitive decline. We demonstrated for the first time that apoA-1, as a blood marker, can predict microstructural changes in white matter regions in PD patients with undisturbed cognition and mild motor disability.
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Affiliation(s)
- Farzaneh Rahmani
- NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hadi Aarabi
- Basir Eye Health Research Center, Vesal'e Shirazi St, Enghelab Sq, Tehran, 14194, Iran.
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Chen YS, Chen MH, Lu CH, Chen PC, Chen HL, Yang IH, Tsai NW, Lin WC. Associations among Cognitive Functions, Plasma DNA, and White Matter Integrity in Patients with Early-Onset Parkinson's Disease. Front Neurosci 2017; 11:9. [PMID: 28174514 PMCID: PMC5258716 DOI: 10.3389/fnins.2017.00009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 01/04/2017] [Indexed: 12/22/2022] Open
Abstract
Early-onset Parkinson's disease (EOPD) patients are symptomatic at a relatively young age, and the impacts of the disease on both the patients and their caregivers are dramatic. Few studies have reported on the cognitive impairments seen in EOPD, and the results of these studies have been diverse. Furthermore, it is still unclear what microstructural white matter (WM) changes are present in EOPD patients. As such, we conducted this study to investigate the microstructural WM changes experienced by EOPD patients and their association with cognitive function and plasma DNA levels. We enrolled 24 EOPD patients and 33 sex- and age-matched healthy volunteers who underwent complete neuro-psychological testing (NPT) to evaluate their cognitive function and diffusion tensor imaging (DTI) scanning to determine their fiber integrity. The plasma DNA measurements included measurements of nuclear and mitochondrial DNA levels. Fractional anisotropy (FA) maps were compared using voxel-based statistics to determine differences between the two groups. The differences in DTI indices and NPT scores were correlated after adjusting for age, sex, and education. Our results demonstrate that patients with EOPD have elevated nuclear DNA levels and wide spectrums of impairments in NPT, especially in the executive function and visuospatial function domains. Exploratory group-wise comparisons of the DTI indices revealed that the patients with EOPD exhibited lower DTI parameters in several brain locations. These poorer DTI parameters were associated with worse cognitive performances and elevated plasma nuclear DNA levels, especially in the anterior thalamic radiation region. Our findings suggest that the thalamus and its adjacent anterior thalamic radiation may be important in the pathogenesis of EOPD, as they appear to become involved in the disease process at an early stage.
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Affiliation(s)
- Yueh-Sheng Chen
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine Kaohsiung, Taiwan
| | - Meng-Hsiang Chen
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine Kaohsiung, Taiwan
| | - Cheng-Hsien Lu
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of MedicineKaohsiung, Taiwan; Department of Biological Science, National Sun Yat-Sen UniversityKaohsiung, Taiwan
| | - Pei-Chin Chen
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine Kaohsiung, Taiwan
| | - Hsiu-Ling Chen
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of MedicineKaohsiung, Taiwan; Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming UniversityTaipei, Taiwan
| | - I-Hsiao Yang
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine Kaohsiung, Taiwan
| | - Nai-Wen Tsai
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine Kaohsiung, Taiwan
| | - Wei-Che Lin
- Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine Kaohsiung, Taiwan
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Salminen LE, Conturo TE, Laidlaw DH, Cabeen RP, Akbudak E, Lane EM, Heaps JM, Bolzenius JD, Baker LM, Cooley S, Scott S, Cagle LM, Phillips S, Paul RH. Regional age differences in gray matter diffusivity among healthy older adults. Brain Imaging Behav 2016; 10:203-11. [PMID: 25864197 DOI: 10.1007/s11682-015-9383-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Aging is associated with microstructural changes in brain tissue that can be visualized using diffusion tensor imaging (DTI). While previous studies have established age-related changes in white matter (WM) diffusion using DTI, the impact of age on gray matter (GM) diffusion remains unclear. The present study utilized DTI metrics of mean diffusivity (MD) to identify age differences in GM/WM microstructure in a sample of healthy older adults (N = 60). A secondary aim was to determine the functional significance of whole-brain GM/WM MD on global cognitive function using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Participants were divided into three age brackets (ages 50-59, 60-69, and 70+) to examine differences in MD and cognition by decade. MD was examined bilaterally in the frontal, temporal, parietal, and occipital lobes for the primary analyses and an aggregate measure of whole-brain MD was used to test relationships with cognition. Significantly higher MD was observed in bilateral GM of the temporal and parietal lobes, and in right hemisphere WM of the frontal and temporal lobes of older individuals. The most robust differences in MD were between the 50-59 and 70+ age groups. Higher whole-brain GM MD was associated with poorer RBANS performance in the 60-69 age group. Results suggest that aging has a significant and differential impact on GM/WM diffusion in healthy older adults, which may explain a modest degree of cognitive variability at specific time points during older adulthood.
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Affiliation(s)
- Lauren E Salminen
- Department of Psychology, University of Missouri- Saint Louis, 1 University Boulevard, Stadler Hall 442 A, Saint Louis, MO, 63121, USA.
| | - Thomas E Conturo
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway, St. Louis, MO, 63110, USA
| | - David H Laidlaw
- Computer Science Department, Brown University, Providence, RI, 02912, USA
| | - Ryan P Cabeen
- Computer Science Department, Brown University, Providence, RI, 02912, USA
| | - Erbil Akbudak
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway, St. Louis, MO, 63110, USA
| | - Elizabeth M Lane
- Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN, 37232, USA
| | - Jodi M Heaps
- Missouri Institute of Mental Health, 4633 World Parkway Circle, Berkeley, MO, 63134-3115, USA
| | - Jacob D Bolzenius
- Department of Psychology, University of Missouri- Saint Louis, 1 University Boulevard, Stadler Hall 442 A, Saint Louis, MO, 63121, USA
| | - Laurie M Baker
- Department of Psychology, University of Missouri- Saint Louis, 1 University Boulevard, Stadler Hall 442 A, Saint Louis, MO, 63121, USA
| | - Sarah Cooley
- Department of Psychology, University of Missouri- Saint Louis, 1 University Boulevard, Stadler Hall 442 A, Saint Louis, MO, 63121, USA
| | - Staci Scott
- Department of Psychology, University of Missouri- Saint Louis, 1 University Boulevard, Stadler Hall 442 A, Saint Louis, MO, 63121, USA
| | - Lee M Cagle
- Department of Psychology, University of Missouri- Saint Louis, 1 University Boulevard, Stadler Hall 442 A, Saint Louis, MO, 63121, USA
| | - Sarah Phillips
- Department of Psychology, University of Missouri- Saint Louis, 1 University Boulevard, Stadler Hall 442 A, Saint Louis, MO, 63121, USA
| | - Robert H Paul
- Department of Psychology, University of Missouri- Saint Louis, 1 University Boulevard, Stadler Hall 442 A, Saint Louis, MO, 63121, USA
- Missouri Institute of Mental Health, 4633 World Parkway Circle, Berkeley, MO, 63134-3115, USA
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Kim M, Park H. Structural connectivity profile of scans without evidence of dopaminergic deficit (SWEDD) patients compared to normal controls and Parkinson's disease patients. SPRINGERPLUS 2016; 5:1421. [PMID: 27625975 PMCID: PMC5001967 DOI: 10.1186/s40064-016-3110-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 08/19/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND In this study, we investigated the structural connectivity profile of patients with scans without evidence of dopaminergic deficit (SWEDD) compared with normal controls (NC) and patients with Parkinson's disease (PD). An accurate understanding of SWEDD is important so that appropriate therapeutic options can be presented to patients. METHODS Diffusion magnetic resonance imaging of NC (n = 40), SWEDD (n = 40) and PD patients (n = 40) was obtained from a research database. Tractography, the process of obtaining fiber information was performed. Connectivity analysis was performed on 16 connections in the cortico-basal ganglia-thalamo-cortical circuit. Group-wise differences among NC, PD and SWEDD patients were quantified in terms of structural connectivity based on fiber density. Then, we investigated correlations with the clinical score using the Movement Disorder Society-Sponsored Unified Parkinson's Disease Rating Scale (MDS-UPDRS). A support vector machine classifier and leave-one-out cross-validation were applied to separate the NC, SWEDD and PD groups. RESULTS Pallidum-putamen and sensorimotor cortex-putamen connections showed significant group-wise differences among NC, PD and SWEDD patients and correlated with the MDS-UPDRS score. CONCLUSIONS Pallidum-putamen and sensorimotor cortex-putamen connections might form a structural connectivity profile unique to SWEDD and could be a potential imaging biomarker for future movement disorder research.
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Affiliation(s)
- Mansu Kim
- Department of Electronic Electrical and Computer Engineering, Sungkyunkwan University, Suwon, Korea
| | - Hyunjin Park
- School of Electronic and Electrical Engineering, Sungkyunkwan University, Suwon, Korea
- Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science, Suwon, Korea
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Alterations of Diffusion Kurtosis and Neurite Density Measures in Deep Grey Matter and White Matter in Parkinson's Disease. PLoS One 2016; 11:e0157755. [PMID: 27362763 PMCID: PMC4928807 DOI: 10.1371/journal.pone.0157755] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Accepted: 06/03/2016] [Indexed: 11/28/2022] Open
Abstract
In Parkinson’s disease (PD), pathological microstructural changes occur and such changes might be detected using diffusion magnetic resonance imaging (dMRI). However, it is unclear whether dMRI improves PD diagnosis or helps differentiating between phenotypes, such as postural instability gait difficulty (PIGD) and tremor dominant (TD) PD. We included 105 patients with PD and 44 healthy controls (HC), all of whom underwent dMRI as part of the prospective Swedish BioFINDER study. Diffusion kurtosis imaging (DKI) and neurite density imaging (NDI) analyses were performed using regions of interest in the basal ganglia, the thalamus, the pons and the midbrain as well as tractography of selected white matter tracts. In the putamen, the PD group showed increased mean diffusivity (MD) (p = .003), decreased fractional anisotropy (FA) (p = .001) and decreased mean kurtosis (MK), compared to HC (p = .024). High MD and a low MK in the putamen were associated with more severe motor and cognitive symptomatology (p < .05). Also, patients with PIGD exhibited increased MD in the putamen compared to the TD patients (p = .009). In the thalamus, MD was increased (p = .001) and FA was decreased (p = .032) in PD compared to HC. Increased MD and decreased FA correlated negatively with motor speed and balance (p < .05). In the superior longitudinal fasciculus (SLF), MD (p = .019) and fiso were increased in PD compared to HC (p = .03). These changes correlated negatively with motor speed (p < .002) and balance (p < .037). However, most of the observed changes in PD were also present in cases with either multiple system atrophy (n = 11) or progressive supranuclear palsy (n = 10). In conclusion, PD patients exhibit microstructural changes in the putamen, the thalamus, and the SLF, which are associated with worse disease severity. However, the dMRI changes are not sufficiently specific to improve the diagnostic work-up of PD. Longitudinal studies should evaluate whether dMRI measures can be used to track disease progression.
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Loane C, Politis M, Kefalopoulou Z, Valle-Guzman N, Paul G, Widner H, Foltynie T, Barker RA, Piccini P. Aberrant nigral diffusion in Parkinson's disease: A longitudinal diffusion tensor imaging study. Mov Disord 2016; 31:1020-6. [DOI: 10.1002/mds.26606] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 02/11/2016] [Accepted: 02/12/2016] [Indexed: 11/11/2022] Open
Affiliation(s)
- Clare Loane
- Neurology Imaging Unit, Hammersmith Hospital, Imperial College London; London UK
- Neurodegeneration Imaging Group, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London; London UK
- Memory Research Group, Nuffield Department of Clinical Neurosciences, University of Oxford; Oxford UK
| | - Marios Politis
- Neurology Imaging Unit, Hammersmith Hospital, Imperial College London; London UK
- Neurodegeneration Imaging Group, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London; London UK
| | - Zinovia Kefalopoulou
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square; London England
| | - Natalie Valle-Guzman
- John Van Geest Centre for Brain Repair, Department of Clinical Neuroscience, University of Cambridge; Cambridge UK
| | - Gesine Paul
- Translational Neurology Group, Department of Clinical Sciences, Wallenberg Neuroscience Center, Lund University; Lund Sweden
| | - Hakan Widner
- Division of Neurology; Department of Clinical Sciences; Lund University, Skane University Hospital; Sweden
| | - Thomas Foltynie
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square; London England
| | - Roger A. Barker
- Department of Clinical Neuroscience; University of Cambridge; Cambridge UK
- MRC Cognition and Brian Sciences Unit; University of Cambridge; Cambridge UK
| | - Paola Piccini
- Neurology Imaging Unit, Hammersmith Hospital, Imperial College London; London UK
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Pereira JLB, B A SF, Sharim J, Yazdi D, DeSalles AAF, Pouratian N. Lateralization of the Subthalamic Nucleus with Age in Parkinson's Disease. ACTA ACUST UNITED AC 2016; 6:83-88. [PMID: 26900546 DOI: 10.1016/j.baga.2016.01.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Age-related changes in subthalamic nucleus (STN) position have not been well characterized in patients with Parkinson's disease (PD). We report a systematic retrospective analysis of age-related changes in radiographic and final deep brain stimulator (DBS) STN coordinates in PD patients. The charts of 134 PD patients (97 males, 28-84 years) representing 255 STN were reviewed. Multiple linear regression, stepwise regression, and relative importance of regressors analysis was performed to determine the significance of the relationship between STN position and age. Across all subjects, both radiographic STN localization and final DBS position within the STN showed a lateralization of the STN target with age (R2=0.1096,p=6.9×10-8 and R2=0.0433,p=8.7×10-4, respectively). Lateralization with age was observed regardless of MR field strength (1.5T and 3.0T) (R2=0.0946,p=7.6×10-6 and R2=0.2687,p=9.2×10-5, respectively). No other consistent or clinically significant age-related changes were identified. Multiple linear regression revealed that the third ventricle width and age are statistically significant predictors of radiographic STN lateralization (R2 = 0.2404, p = 1.51×10-5 and p = .00784 respectively). Step-wise regression demonstrated that age is a non-redundant predictor of STN lateralization relative to third ventricle width. Similar to healthy controls, STN position appears to shift laterally with age in PD. This highlights limitations of indirect targeting and atlas-based stereotactic surgery and argues for reliance on patient specific anatomy since factors such as age and 3rd ventricular width can contribute to patient-specific variability in STN localization.
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Affiliation(s)
- Julio L B Pereira
- Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, USA
| | - Sydney Furie B A
- Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, USA
| | - Justin Sharim
- Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, USA
| | - Daniel Yazdi
- Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, USA
| | - Antonio A F DeSalles
- Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, USA
| | - Nader Pouratian
- Department of Neurosurgery, David Geffen School of Medicine, University of California Los Angeles, USA; Department of Bioengineering, David Geffen School of Medicine, University of California Los Angeles, USA; Neuroscience Interdepartmental Program, David Geffen School of Medicine, University of California Los Angeles, USA; Brain Research Institute, David Geffen School of Medicine, University of California Los Angeles, USA
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Using Tractography to Distinguish SWEDD from Parkinson's Disease Patients Based on Connectivity. PARKINSONS DISEASE 2016; 2016:8704910. [PMID: 27034889 PMCID: PMC4789533 DOI: 10.1155/2016/8704910] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 02/03/2016] [Accepted: 02/10/2016] [Indexed: 11/18/2022]
Abstract
Background. It is critical to distinguish between Parkinson's disease (PD) and scans without evidence of dopaminergic deficit (SWEDD), because the two groups are different and require different therapeutic approaches. Objective. The aim of this study was to distinguish SWEDD patients from PD patients using connectivity information derived from diffusion tensor imaging tractography. Methods. Diffusion magnetic resonance images of SWEDD (n = 37) and PD (n = 40) were obtained from a research database. Tractography, the process of obtaining neural fiber information, was performed using custom software. Group-wise differences between PD and SWEDD patients were quantified using the number of connected fibers between two regions, and correlation analyses were performed based on clinical scores. A support vector machine classifier (SVM) was applied to distinguish PD and SWEDD based on group-wise differences. Results. Four connections showed significant group-wise differences and correlated with the Unified Parkinson's Disease Rating Scale sponsored by the Movement Disorder Society. The SVM classifier attained 77.92% accuracy in distinguishing between SWEDD and PD using these identified connections. Conclusions. The connections and regions identified represent candidates for future research investigations.
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Nagae LM, Honce JM, Tanabe J, Shelton E, Sillau SH, Berman BD. Microstructural Changes within the Basal Ganglia Differ between Parkinson Disease Subtypes. Front Neuroanat 2016; 10:17. [PMID: 26941615 PMCID: PMC4763054 DOI: 10.3389/fnana.2016.00017] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 02/08/2016] [Indexed: 11/13/2022] Open
Abstract
Diffusion tensor imaging (DTI) of the substantia nigra has shown promise in detecting and quantifying neurodegeneration in Parkinson disease (PD). It remains unknown, however, whether differences in microstructural changes within the basal ganglia underlie PD motor subtypes. We investigated microstructural changes within the basal ganglia of mild to moderately affected PD patients using DTI and sought to determine if microstructural changes differ between the tremor dominant (TD) and postural instability/gait difficulty (PIGD) subtypes. Fractional anisotropy, mean diffusivity, radial, and axial diffusivity were obtained from bilateral caudate, putamen, globus pallidus, and substantia nigra of 21 PD patients (12 TD and 9 PIGD) and 20 age-matched healthy controls. T-tests and ANOVA methods were used to compare PD patients, subtypes, and controls, and Spearman correlations tested for relationships between DTI and clinical measures. We found our cohort of PD patients had reduced fractional anisotropy within the substantia nigra and increased mean and radial diffusivity within the substantia nigra and globus pallidus compared to controls, and that changes within those structures were largely driven by the PIGD subtype. Across all PD patients fractional anisotropy within the substantia nigra correlated with disease stage, while in PIGD patients increased diffusivity within the globus pallidus correlated with disease stage and motor severity. We conclude that PIGD patients have more severely affected microstructural changes within the substantia nigra compared to TD, and that microstructural changes within the globus pallidus may be particularly relevant for the manifestation of the PIGD subtype.
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Affiliation(s)
- Lidia M Nagae
- Department of Radiology, University of Colorado Anschutz Medial Campus Aurora, CO, USA
| | - Justin M Honce
- Department of Radiology, University of Colorado Anschutz Medial Campus Aurora, CO, USA
| | - Jody Tanabe
- Department of Radiology, University of Colorado Anschutz Medial Campus Aurora, CO, USA
| | - Erika Shelton
- Department of Neurology, University of Colorado Anschutz Medial Campus Aurora, CO, USA
| | - Stefan H Sillau
- Department of Neurology, University of Colorado Anschutz Medial Campus Aurora, CO, USA
| | - Brian D Berman
- Department of Radiology, University of Colorado Anschutz Medial CampusAurora, CO, USA; Department of Neurology, University of Colorado Anschutz Medial CampusAurora, CO, USA; Neurology Section, Denver VA Medical CenterDenver, CO, USA
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Avecillas-Chasin JM, Rascón-Ramírez F, Barcia JA. Tractographical model of the cortico-basal ganglia and corticothalamic connections. Clin Anat 2016; 29:481-92. [DOI: 10.1002/ca.22689] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 12/16/2015] [Accepted: 01/06/2016] [Indexed: 11/08/2022]
Affiliation(s)
| | - Fernando Rascón-Ramírez
- Department of Neurosurgery; Institute of Neurosciences, Instituto De Investigación Sanitaria San Calos, Hospital Clínico San Carlos; Madrid Spain
| | - Juan A. Barcia
- Department of Neurosurgery; Institute of Neurosciences, Instituto De Investigación Sanitaria San Calos, Hospital Clínico San Carlos; Madrid Spain
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Planetta PJ, Ofori E, Pasternak O, Burciu RG, Shukla P, DeSimone JC, Okun MS, McFarland NR, Vaillancourt DE. Free-water imaging in Parkinson's disease and atypical parkinsonism. Brain 2015; 139:495-508. [PMID: 26705348 DOI: 10.1093/brain/awv361] [Citation(s) in RCA: 148] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 10/26/2015] [Indexed: 12/11/2022] Open
Abstract
Conventional single tensor diffusion analysis models have provided mixed findings in the substantia nigra of Parkinson's disease, but recent work using a bi-tensor analysis model has shown more promising results. Using a bi-tensor model, free-water values were found to be increased in the posterior substantia nigra of Parkinson's disease compared with controls at a single site and in a multi-site cohort. Further, free-water increased longitudinally over 1 year in the posterior substantia nigra of Parkinson's disease. Here, we test the hypothesis that other parkinsonian disorders such as multiple system atrophy and progressive supranuclear palsy have elevated free-water in the substantia nigra. Equally important, however, is whether the bi-tensor diffusion model is able to detect alterations in other brain regions beyond the substantia nigra in Parkinson's disease, multiple system atrophy, and progressive supranuclear palsy and to accurately distinguish between these diseases. Free-water and free-water-corrected fractional anisotropy maps were compared across 72 individuals in the basal ganglia, midbrain, thalamus, dentate nucleus, cerebellar peduncles, cerebellar vermis and lobules V and VI, and corpus callosum. Compared with controls, free-water was increased in the anterior and posterior substantia nigra of Parkinson's disease, multiple system atrophy, and progressive supranuclear palsy. Despite no other changes in Parkinson's disease, we observed elevated free-water in all regions except the dentate nucleus, subthalamic nucleus, and corpus callosum of multiple system atrophy, and in all regions examined for progressive supranuclear palsy. Compared with controls, free-water-corrected fractional anisotropy values were increased for multiple system atrophy in the putamen and caudate, and increased for progressive supranuclear palsy in the putamen, caudate, thalamus, and vermis, and decreased in the superior cerebellar peduncle and corpus callosum. For all disease group comparisons, the support vector machine 10-fold cross-validation area under the curve was between 0.93-1.00 and there was high sensitivity and specificity. The regions and diffusion measures selected by the model varied across comparisons and are consistent with pathological studies. In conclusion, the current study used a novel bi-tensor diffusion analysis model to indicate that all forms of parkinsonism had elevated free-water in the substantia nigra. Beyond the substantia nigra, both multiple system atrophy and progressive supranuclear palsy, but not Parkinson's disease, showed a broad network of elevated free-water and altered free-water corrected fractional anisotropy that included the basal ganglia, thalamus, and cerebellum. These findings may be helpful in the differential diagnosis of parkinsonian disorders, and thereby facilitate the development and assessment of targeted therapies.
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Affiliation(s)
- Peggy J Planetta
- 1 Department of Applied Physiology and Kinesiology, University of Florida, USA
| | - Edward Ofori
- 1 Department of Applied Physiology and Kinesiology, University of Florida, USA
| | - Ofer Pasternak
- 2 Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, USA
| | - Roxana G Burciu
- 1 Department of Applied Physiology and Kinesiology, University of Florida, USA
| | - Priyank Shukla
- 1 Department of Applied Physiology and Kinesiology, University of Florida, USA
| | - Jesse C DeSimone
- 1 Department of Applied Physiology and Kinesiology, University of Florida, USA
| | - Michael S Okun
- 3 Center for Movement Disorders and Neurorestoration, University of Florida, USA 4 Department of Neurology, University of Florida, USA 5 Department of Neurosurgery, University of Florida, USA
| | - Nikolaus R McFarland
- 3 Center for Movement Disorders and Neurorestoration, University of Florida, USA 4 Department of Neurology, University of Florida, USA
| | - David E Vaillancourt
- 1 Department of Applied Physiology and Kinesiology, University of Florida, USA 4 Department of Neurology, University of Florida, USA 6 Department of Biomedical Engineering, University of Florida, USA
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Weingarten CP, Sundman MH, Hickey P, Chen NK. Neuroimaging of Parkinson's disease: Expanding views. Neurosci Biobehav Rev 2015; 59:16-52. [PMID: 26409344 PMCID: PMC4763948 DOI: 10.1016/j.neubiorev.2015.09.007] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 09/07/2015] [Accepted: 09/15/2015] [Indexed: 12/14/2022]
Abstract
Advances in molecular and structural and functional neuroimaging are rapidly expanding the complexity of neurobiological understanding of Parkinson's disease (PD). This review article begins with an introduction to PD neurobiology as a foundation for interpreting neuroimaging findings that may further lead to more integrated and comprehensive understanding of PD. Diverse areas of PD neuroimaging are then reviewed and summarized, including positron emission tomography, single photon emission computed tomography, magnetic resonance spectroscopy and imaging, transcranial sonography, magnetoencephalography, and multimodal imaging, with focus on human studies published over the last five years. These included studies on differential diagnosis, co-morbidity, genetic and prodromal PD, and treatments from L-DOPA to brain stimulation approaches, transplantation and gene therapies. Overall, neuroimaging has shown that PD is a neurodegenerative disorder involving many neurotransmitters, brain regions, structural and functional connections, and neurocognitive systems. A broad neurobiological understanding of PD will be essential for translational efforts to develop better treatments and preventive strategies. Many questions remain and we conclude with some suggestions for future directions of neuroimaging of PD.
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Affiliation(s)
- Carol P Weingarten
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, United States.
| | - Mark H Sundman
- Brain Imaging and Analysis Center, Duke University Medical Center, United States
| | - Patrick Hickey
- Department of Neurology, Duke University School of Medicine, United States
| | - Nan-kuei Chen
- Brain Imaging and Analysis Center, Duke University Medical Center, United States; Department of Radiology, Duke University School of Medicine, United States
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Li C, Wang R, Chen H, Su W, Li S, Zhao X, Zhou J, Qiao J, Lou B, Song G, Chen M. Chemical Exchange Saturation Transfer MR Imaging is Superior to Diffusion-Tensor Imaging in the Diagnosis and Severity Evaluation of Parkinson's Disease: A Study on Substantia Nigra and Striatum. Front Aging Neurosci 2015; 7:198. [PMID: 26539109 PMCID: PMC4609848 DOI: 10.3389/fnagi.2015.00198] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 10/04/2015] [Indexed: 12/28/2022] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder characterized by nigrostriatal cell loss. To date, the diagnosis of PD is still based primarily on the clinical manifestations, which may be typical and obvious only in advanced-stage PD. Thus, it is crucial to find a reliable marker for the diagnosis of PD. We conducted this study to assess the diagnostic efficiency of chemical exchange saturation transfer (CEST) imaging and diffusion-tensor imaging (DTI) in PD at 3 T by evaluating changes on substantia nigra and striatum. Twenty-three PD patients and twenty-three age-matched normal controls were recruited. All patients and controls were imaged on a 3-T MR system, using an eight-channel head coil. CEST imaging was acquired in two transverse slices of the head, including substantia nigra and striatum. The magnetization transfer ratio asymmetry at 3.5 ppm, MTRasym(3.5 ppm), and the total CEST signal intensity between 0 and 4 ppm were calculated. Multi-slice DTI was acquired for all the patients and normal controls. Quantitative analysis was performed on the substantia nigra, globus pallidus, putamen, and caudate. The MTRasym(3.5 ppm) value, the total CEST signal intensity, and fractional anisotropy value of the substantia nigra were all significantly lower in PD patients than in normal controls (P = 0.003, P = 0.004, and P < 0.001, respectively). The MTRasym(3.5 ppm) values of the putamen and the caudate were significantly higher in PD patients than in normal controls (P = 0.010 and P = 0.009, respectively). There were no significant differences for the mean diffusivity in these four regions between PD patients and normal controls. In conclusion, CEST MR imaging provided multiple CEST image contrasts in the substantia nigra and the striatum in PD and may be superior to DTI in the diagnosis of PD.
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Affiliation(s)
- Chunmei Li
- Department of Radiology, Beijing Hospital, Beijing, China
| | - Rui Wang
- Department of Radiology, Beijing Hospital, Beijing, China
| | - Haibo Chen
- Department of Neurology, Beijing Hospital, Beijing, China
| | - Wen Su
- Department of Neurology, Beijing Hospital, Beijing, China
| | - Shuhua Li
- Department of Neurology, Beijing Hospital, Beijing, China
| | - Xuna Zhao
- Department of Radiology, Johns Hopkins University, Baltimore, MD, USA
- Philips Healthcare, Beijing, China
| | - Jinyuan Zhou
- Department of Radiology, Johns Hopkins University, Baltimore, MD, USA
| | - Jian Qiao
- Department of Radiology, Beijing Hospital, Beijing, China
| | - Baohui Lou
- Department of Radiology, Beijing Hospital, Beijing, China
| | - Guodong Song
- Department of Radiology, Beijing Hospital, Beijing, China
| | - Min Chen
- Department of Radiology, Beijing Hospital, Beijing, China
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Lenfeldt N, Larsson A, Nyberg L, Birgander R, Forsgren L. Fractional anisotropy in the substantia nigra in Parkinson's disease: a complex picture. Eur J Neurol 2015; 22:1408-14. [PMID: 26118635 DOI: 10.1111/ene.12760] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 04/27/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND PURPOSE This study employs magnetic resonance imaging (MRI) diffusion tensor imaging to compare diffusion measures in the brains of patients with Parkinson's disease (PD) with healthy controls using longitudinal data. METHODS One-hundred and twenty-two patients and 34 controls were included at baseline. The MRI investigations were repeated after 1, 3 and 5 years. The diffusion measures were quantified using fractional anisotropy and mean, radial and axial diffusion (FA, MD, RD, AD). Regions of interest included the anterior, middle and posterior substantia nigra (SN), but also other areas. Linear models were used to test for the effect of disease and hemispheric lateralization. The P value was set at 0.05 (Bonferroni corrected). RESULTS Fractional anisotropy and AD were increased in the three nigral subareas in PD (P < 0.01), but MD and RD were unaltered. The right SN had higher FA than the left in all subareas (P < 0.01). MD and AD were increased in the right anterior part (P < 0.04), whereas MD and RD were decreased in the right middle and posterior parts (P < 0.001). The left middle cerebellar peduncle had increased FA and AD (P < 0.001) and decreased MD and RD (P < 0.01) compared to the right. Diffusion measures did not progress over time and side differences were not related to disease or lateralization of symptoms. CONCLUSIONS Increased FA in the SN in PD indicates gliosis and inflammation in the nuclei, but possibly also intrusion of surrounding fibres into the shrinking structure. The hemispheric side differences of diffusion might reflect natural lateralization of connectivity, but their relation to PD must be studied further.
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Affiliation(s)
- N Lenfeldt
- Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden
| | - A Larsson
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
| | - L Nyberg
- Department of Radiation Sciences, Umeå University, Umeå, Sweden.,Department of Integrative Medical Biology, Umeå University, Umeå, Sweden
| | - R Birgander
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
| | - L Forsgren
- Department of Pharmacology and Clinical Neuroscience, Umeå University, Umeå, Sweden
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Decreased Resting-State Interhemispheric Functional Connectivity in Parkinson's Disease. BIOMED RESEARCH INTERNATIONAL 2015; 2015:692684. [PMID: 26180807 PMCID: PMC4477209 DOI: 10.1155/2015/692684] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 09/27/2014] [Accepted: 10/10/2014] [Indexed: 02/05/2023]
Abstract
BACKGROUND Abnormalities in white matter integrity and specific functional network alterations have been increasingly reported in patients with Parkinson's disease (PD). However, little is known about the inter-hemispheric interaction in PD. METHODS Fifty-one drug naive patients with PD and 51 age- and gender-matched healthy subjects underwent resting-state functional magnetic resonance imaging (rs-fMRI) scans. We compared the inter-hemispheric resting-state functional connectivity between patients with PD and healthy controls, using the voxel-mirrored homotopic connectivity (VMHC) approach. Then, we correlated the results from VMHC and clinical features in PD patients. RESULTS Relative to healthy subject, patients exhibited significantly lower VMHC in putamen and cortical regions associated with sensory processing and motor control (involving sensorimotor and supramarginal cortex), which have been verified to play a critical role in PD. In addition, there were inverse relationships between the UPDRS motor scores and VMHC in the sensorimotor, and between the illness duration and VMHC in the supramarginal gyrus in PD patients. CONCLUSIONS Our results suggest that the functional coordination between homotopic brain regions is impaired in PD patients, extending previous notions about the disconnection of corticostriatal circuit by providing new evidence supporting a disturbance in inter-hemispheric connections in PD.
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Abstract
Vertebrate myelination is an evolutionary advancement essential for motor, sensory, and higher-order cognitive function. CNS myelin, a multilamellar differentiation of the oligodendrocyte plasma membrane, ensheaths axons to facilitate electrical conduction. Myelination is one of the most pivotal cell-cell interactions for normal brain development, involving extensive information exchange between differentiating oligodendrocytes and axons. The molecular mechanisms of myelination are discussed, along with new perspectives on oligodendrocyte plasticity and myelin remodeling of the developing and adult CNS.
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Vercruysse S, Leunissen I, Vervoort G, Vandenberghe W, Swinnen S, Nieuwboer A. Microstructural changes in white matter associated with freezing of gait in Parkinson's disease. Mov Disord 2015; 30:567-76. [PMID: 25640958 DOI: 10.1002/mds.26130] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Revised: 12/03/2014] [Accepted: 12/05/2014] [Indexed: 11/09/2022] Open
Abstract
In Parkinson's disease (PD), freezing of gait (FOG) is associated with widespread functional and structural gray matter changes throughout the brain. Previous study of freezing-related white matter changes was restricted to brainstem and cerebellar locomotor tracts. This study was undertaken to determine the spatial distribution of white matter damage associated with FOG by combining whole brain and striatofrontal seed-based diffusion tensor imaging. Diffusion-weighted images were collected in 26 PD patients and 16 age-matched controls. Parkinson's disease groups with (n = 11) and without freezing of gait (n = 15) were matched for age and disease severity. We applied tract-based spatial statistics to compare fractional anisotropy and mean diffusivity of white matter structure across the whole brain between groups. Probabilistic tractography was used to evaluate fractional anisotropy and mean diffusivity of key subcortico-cortical tracts. Tract-based spatial statistics revealed decreased fractional anisotropy in PD with FOG in bilateral cerebellar and superior longitudinal fascicle clusters. Increased mean diffusivity values were apparent in the right internal capsule, superior frontal cortex, anterior corona radiata, the left anterior thalamic radiation, and cerebellum. Tractography showed consistent white matter alterations in striatofrontal tracts through the putamen, caudate, pallidum, subthalamic nucleus, and in connections of the cerebellar peduncle with subthalamic nucleus and pedunculopontine nucleus bilaterally. We conclude that FOG is associated with diffuse white matter damage involving major cortico-cortical, corticofugal motor, and several striatofrontal tracts in addition to previously described cerebello-pontine connectivity changes. These distributed white matter abnormalities may contribute to the motor and non-motor correlates of FOG.
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Affiliation(s)
- Sarah Vercruysse
- Katholieke Universiteit Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
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Douet V, Chang L. Fornix as an imaging marker for episodic memory deficits in healthy aging and in various neurological disorders. Front Aging Neurosci 2015; 6:343. [PMID: 25642186 PMCID: PMC4294158 DOI: 10.3389/fnagi.2014.00343] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 12/14/2014] [Indexed: 01/12/2023] Open
Abstract
The fornix is a part of the limbic system and constitutes the major efferent and afferent white matter tracts from the hippocampi. The underdevelopment of or injuries to the fornix are strongly associated with memory deficits. Its role in memory impairments was suggested long ago with cases of surgical forniceal transections. However, recent advances in brain imaging techniques, such as diffusion tensor imaging, have revealed that macrostructural and microstructural abnormalities of the fornix correlated highly with declarative and episodic memory performance. This structure appears to provide a robust and early imaging predictor for memory deficits not only in neurodegenerative and neuroinflammatory diseases, such as Alzheimer's disease and multiple sclerosis, but also in schizophrenia and psychiatric disorders, and during neurodevelopment and “typical” aging. The objective of the manuscript is to present a systematic review regarding published brain imaging research on the fornix, including the development of its tracts, its role in various neurological diseases, and its relationship to neurocognitive performance in human studies.
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Affiliation(s)
- Vanessa Douet
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii Honolulu, HI, USA
| | - Linda Chang
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii Honolulu, HI, USA
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Youn J, Lee JM, Kwon H, Kim JS, Son TO, Cho JW. Alterations of mean diffusivity of pedunculopontine nucleus pathway in Parkinson's disease patients with freezing of gait. Parkinsonism Relat Disord 2015; 21:12-7. [DOI: 10.1016/j.parkreldis.2014.10.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 09/29/2014] [Accepted: 10/01/2014] [Indexed: 11/29/2022]
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Diffusion tensor imaging parameters' changes of cerebellar hemispheres in Parkinson's disease. Neuroradiology 2014; 57:327-34. [PMID: 25479963 DOI: 10.1007/s00234-014-1473-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 11/24/2014] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Studies with diffusion tensor imaging (DTI) analysis have produced conflicting information about the involvement of the cerebellar hemispheres in Parkinson's disease (PD). We, thus, used a new approach for the analysis of DTI parameters in order to ascertain the involvement of the cerebellum in PD. METHODS We performed a fiber tract-based analysis of cerebellar peduncles and cerebellar hemispheres in 16 healthy subjects and in 16 PD patients with more than 5 years duration of disease, using a 3T MRI scanner and a constrained spherical deconvolution (CSD) approach for tractographic reconstructions. In addition, we performed statistical analysis of DTI parameters and fractional anisotropy (FA) XYZ direction samplings. RESULTS We found a statistically significant decrement of FA values in PD patients compared to controls (p < 0.05). In addition, extrapolating and analyzing FA XYZ direction samplings for each patient and each control, we found that this result was due to a stronger decrement of FA values along the Y axis (antero-posterior direction) (p < 0.01); FA changes along X and Z axes were not statistically significant (p > 0.05). We confirmed also no statistically significant differences of FA and apparent diffusion coefficient (ADC) for cerebellar peduncles in PD patients compared to healthy controls. CONCLUSIONS The DTI-based cerebellar abnormalities in PD could constitute an advance in the knowledge of this disease. We demonstrated a statistically significant reduction of FA in cerebellar hemispheres of PD patients compared to healthy controls. Our work also demonstrated that the use of more sophisticated approaches in the DTI parameter analysis could potentially have a clinical relevance.
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Potgieser AR, van der Hoorn A, Meppelink AM, Teune LK, Koerts J, de Jong BM. Anterior Temporal Atrophy and Posterior Progression in Patients with Parkinson's Disease. NEURODEGENER DIS 2014; 14:125-32. [DOI: 10.1159/000363245] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 04/28/2014] [Indexed: 11/19/2022] Open
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Imaging changes associated with cognitive abnormalities in Parkinson's disease. Brain Struct Funct 2014; 220:2249-61. [PMID: 24816399 DOI: 10.1007/s00429-014-0785-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 04/22/2014] [Indexed: 01/12/2023]
Abstract
The current study investigates both gray and white matter changes in non-demented Parkinson's disease (PD) patients with varying degrees of mild cognitive deficits and elucidates the relationships between the structural changes and clinical sequelae of PD. Twenty-six PD patients and 15 healthy controls (HCs) were enrolled in the study. Participants underwent T1-weighted and diffusion tensor imaging (DTI) scans. Their cognition was assessed using a neuropsychological battery. Compared with HCs, PD patients showed significant cortical thinning in sensorimotor (left pre- and postcentral gyri) and cognitive (left dorsolateral superior frontal gyrus [DLSFG]) regions. The DLSFG cortical thinning correlated with executive and global cognitive impairment in PD patients. PD patients showed white matter abnormalities as well, primarily in bilateral frontal and temporal regions, which also correlated with executive and global cognitive impairment. These results seem to suggest that both gray and white matter changes in the frontal regions may constitute an early pathological substrate of cognitive impairment of PD providing a sensitive biomarker for brain changes in PD.
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Rosso AL, Olson Hunt MJ, Yang M, Brach JS, Harris TB, Newman AB, Satterfield S, Studenski SA, Yaffe K, Aizenstein HJ, Rosano C. Higher step length variability indicates lower gray matter integrity of selected regions in older adults. Gait Posture 2014; 40:225-30. [PMID: 24792638 PMCID: PMC4071448 DOI: 10.1016/j.gaitpost.2014.03.192] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 03/24/2014] [Accepted: 03/31/2014] [Indexed: 02/02/2023]
Abstract
Step length variability (SLV) increases with age in those without overt neurologic disease, is higher in neurologic patients, is associated with falls, and predicts dementia. Whether higher SLV in older adults without neurologic disease indicates presence of neurologic abnormalities is unknown. Our objective was to identify whether SLV in older adults without overt disease is associated with findings from multimodal neuroimaging. A well-characterized cohort of 265 adults (79-90 years) was concurrently assessed by gait mat, magnetic resonance imaging with diffusion tensor, and neurological exam. Linear regression models adjusted for gait speed, demographic, health, and functional covariates assessed associations of MRI measures (gray matter volume, white matter hyperintensity volume, mean diffusivity, fractional anisotropy) with SLV. Regional distribution of associations was assessed by sparse partial least squares analyses. Higher SLV (mean: 8.4, SD: 3.3) was significantly associated with older age, slower gait speed, and poorer executive function and also with lower gray matter integrity measured by mean diffusivity (standardized beta=0.16; p=0.02). Associations between SLV and gray matter integrity were strongest for the hippocampus and anterior cingulate gyrus (both β=0.18) as compared to other regions. Associations of SLV with other neuroimaging markers were not significant. Lower integrity of normal-appearing gray matter may underlie higher SLV in older adults. Our results highlighted the hippocampus and anterior cingulate gyrus, regions involved in memory and executive function. These findings support previous research indicating a role for cognitive function in motor control. Higher SLV may indicate focal neuropathology in those without diagnosed neurologic disease.
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Affiliation(s)
- Andrea L Rosso
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA
| | - Megan J Olson Hunt
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA
| | - Mei Yang
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA
| | - Jennifer S Brach
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, USA
| | - Tamara B Harris
- Laboratory of Epidemiology, Demography, and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, USA
| | - Anne B Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA
| | - Suzanne Satterfield
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, USA
| | - Stephanie A Studenski
- Division of Geriatric Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, USA
| | - Kristine Yaffe
- Department of Psychiatry, University of California, San Francisco, USA
| | | | - Caterina Rosano
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA
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Fully automated detection of corticospinal tract damage in chronic stroke patients. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2014; 2014:370849. [PMID: 24527059 PMCID: PMC3914349 DOI: 10.1155/2014/370849] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 12/24/2013] [Indexed: 11/29/2022]
Abstract
Structural integrity of the corticospinal tract (CST) after stroke is closely linked to the degree of motor impairment. However, current methods for measurement of fractional atrophy (FA) of CST based on region of interest (ROI) are time-consuming and open to bias. Here, we used tract-based spatial statistics (TBSS) together with a CST template with healthy volunteers to quantify structural integrity of CST automatically. Two groups of patients after ischemic stroke were enrolled, group 1 (10 patients, 7 men, and Fugl-Meyer assessment (FMA) scores ⩽ 50) and group 2 (12 patients, 12 men, and FMA scores = 100). CST of FAipsi, FAcontra, and FAratio was compared between the two groups. Relative to group 2, FA was decreased in group 1 in the ipsilesional CST (P < 0.01), as well as the FAratio (P < 0.01). There was no significant difference between the two subgroups in the contralesional CST (P = 0.23). Compared with contralesional CST, FA of ipsilesional CST decreased in group 1 (P < 0.01). These results suggest that the automated method used in our study could detect a surrogate biomarker to quantify the CST after stroke, which would facilitate implementation of clinical practice.
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