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Street D, Bevan-Jones WR, Malpetti M, Jones PS, Passamonti L, Ghosh BC, Rittman T, Coyle-Gilchrist IT, Allinson K, Dawson CE, Rowe JB. Structural correlates of survival in progressive supranuclear palsy. Parkinsonism Relat Disord 2023; 116:105866. [PMID: 37804622 PMCID: PMC7615224 DOI: 10.1016/j.parkreldis.2023.105866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/12/2023] [Accepted: 09/25/2023] [Indexed: 10/09/2023]
Abstract
INTRODUCTION Many studies of the Richardson's syndrome phenotype of progressive supranuclear palsy (PSP) have elucidated regions of progressive atrophy and neural correlates of clinical severity. However, the neural correlates of survival and how these differ according to variant phenotypes are poorly understood. We set out to identify structural changes that predict severity and survival from scanning date to death. METHODS Structural magnetic resonance imaging data from 112 deceased people with clinically defined 'probable' or 'possible' PSP were analysed. Neuroanatomical regions of interest volumes, thickness and area were correlated with 'temporal stage', defined as the ratio of time from symptom onset to death, time from scan to death ('survival from scan'), and in a subset of patients, clinical severity, adjusting for age and total intracranial volume. Forty-nine participants had post mortem confirmation of the diagnosis. RESULTS Using T1-weighted magnetic resonance imaging, we confirmed the midbrain, and bilateral cortical structural correlates of contemporary disease severity. Atrophy of the striatum, cerebellum and frontotemporal cortex correlate with temporal stage and survival from scan, even after adjusting for severity. Subcortical structure-survival relationships were stronger in Richardson's syndrome than variant phenotypes. CONCLUSIONS Although the duration of PSP varies widely between people, an individual's progress from disease onset to death (their temporal stage) reflects atrophy in striatal, cerebellar and frontotemporal cortical regions. Our findings suggest magnetic resonance imaging may contribute to prognostication and stratification of patients with heterogenous clinical trajectories and clarify the processes that confer mortality risk in PSP.
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Affiliation(s)
- Duncan Street
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, UK
| | | | - Maura Malpetti
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, UK
| | - P Simon Jones
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, UK
| | - Luca Passamonti
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, UK; Consiglio Nazionale Delle Ricerche (CNR), Istituto di Bioimmagini e Fisiologia Molecolare (IBFM), Milano, Italy
| | - Boyd Cp Ghosh
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, UK; Wessex Neurological Centre, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - Timothy Rittman
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, UK
| | - Ian Ts Coyle-Gilchrist
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, UK; Norfolk and Norwich NHS Foundation Trust, Norwich, UK
| | - Kieren Allinson
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, UK; Department of Pathology, Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - Catherine E Dawson
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, UK
| | - James B Rowe
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, UK; MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK.
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Ahn JH, Kwon J, Won JH, Byeon K, Youn J, Park H, Cho JW. Waiting impulsivity in progressive supranuclear palsy-Richardson's syndrome. Front Neurosci 2023; 17:1240709. [PMID: 37817800 PMCID: PMC10560850 DOI: 10.3389/fnins.2023.1240709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/06/2023] [Indexed: 10/12/2023] Open
Abstract
Background Waiting impulsivity in progressive supranuclear palsy-Richardson's syndrome (PSP-RS) is difficult to assess, and its regulation is known to involve nucleus accumbens (NAc) subregions. We investigated waiting impulsivity using the "jumping the gun" (JTG) sign, which is defined as premature initiation of clapping before the start signal in the three-clap test and compared clinical features of PSP-RS patients with and without the sign and analyzed neural connectivity and microstructural changes in NAc subregions. Materials and methods A positive JTG sign was defined as the participant starting to clap before the start sign in the three-clap test. We classified participants into the JTG positive (JTG +) and JTG negative (JTG-) groups and compared their clinical features, microstructural changes, and connectivity between NAc subregions using diffusion tension imaging. The NAc was parcellated into core and shell subregions using data-driven connectivity-based methods. Results Seventy-seven patients with PSP-RS were recruited, and the JTG + group had worse frontal lobe battery (FAB) scores, more frequent falls, and more occurrence of the applause sign than the JTG- group. A logistic regression analysis revealed that FAB scores were associated with a positive JTG sign. The mean fiber density between the right NAc core and right medial orbitofrontal gyrus was higher in the JTG + group than the JTG- group. Discussion We show that the JTG sign is a surrogate marker of waiting impulsivity in PSP-RS patients. Our findings enrich the current literature by deepening our understanding of waiting impulsivity in PSP patients and introducing a novel method for its evaluation.
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Affiliation(s)
- Jong Hyeon Ahn
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Junmo Kwon
- Department of Electrical and Computer Engineering, Sungkyunkwan University, Suwon-si, Republic of Korea
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon-si, Republic of Korea
| | - Ji Hye Won
- Department of Computer Engineering, Pukyong National University, Busan, Republic of Korea
| | - Kyoungseob Byeon
- Department of Electrical and Computer Engineering, Sungkyunkwan University, Suwon-si, Republic of Korea
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon-si, Republic of Korea
| | - Jinyoung Youn
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Hyunjin Park
- Department of Electrical and Computer Engineering, Sungkyunkwan University, Suwon-si, Republic of Korea
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon-si, Republic of Korea
| | - Jin Whan Cho
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea
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Tsai CC, Chen YL, Lu CS, Cheng JS, Weng YH, Lin SH, Wu YM, Wang JJ. Diffusion Tensor Imaging for the differential diagnosis of Parkinsonism by machine learning. Biomed J 2022; 46:100541. [DOI: 10.1016/j.bj.2022.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 04/28/2022] [Accepted: 05/27/2022] [Indexed: 11/02/2022] Open
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Chen Q, Li X, Li L, Lu J, Sun Y, Liu F, Zuo C, Wang J. Dopamine transporter imaging in progressive supranuclear palsy: Severe but nonspecific to subtypes. Acta Neurol Scand 2022; 146:237-245. [PMID: 35611608 DOI: 10.1111/ane.13653] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 05/07/2022] [Accepted: 05/11/2022] [Indexed: 12/26/2022]
Abstract
BACKGROUND Previous studies with a limited sample size suggested more severe dopaminergic transporter (DAT) lesions in the striatum of progressive supranuclear palsy (PSP) than those in Parkinson's disease (PD) and multiple system atrophy-parkinsonism (MSA-P). However, few studies had taken various subtypes of PSP into consideration, making the reanalysis of DAT imaging in larger PSP cohort with various subtypes in need. OBJECTIVES To compare the dopaminergic lesion patterns of PSP with MSA-P and PD, and to explore the specific striatal subregional patterns of different PSP subtypes. METHODS 11 C-CFT positron emission tomography (PET) imaging was conducted in 83 PSP patients consisting of different subtypes, 61 patients with PD, 41 patients with MSA-P, and 43 healthy volunteers. Demographic and clinical data were compared by the chi-squared test or one-way analysis of variance. A generalized linear model was used to examine intergroup differences in tracer uptake values after adjusting for age, disease duration, and disease severity. Areas under the receiver operating characteristic curve were calculated to assess the diagnostic accuracy of subregional DAT binding patterns. RESULTS The patients with PSP presented more severe DAT loss in the striatum than in PD and MSA-P, especially in caudate. In PSP, the subregional lesion was still more severe in putamen than in caudate, similar to that in PD and MSA-P. Among detailed subtypes, no significant difference was detected. CONCLUSION The dopaminergic lesions were more severe in PSP, and no difference was detected among subtypes.
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Affiliation(s)
- Qi‐Si Chen
- Department of Neurology, National Clinical Research Center for Aging and Medicine, National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital Fudan University Shanghai China
| | - Xin‐Yi Li
- Department of Neurology, National Clinical Research Center for Aging and Medicine, National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital Fudan University Shanghai China
| | - Ling Li
- PET Center, National Clinical Research Center for Aging and Medicine, National Center for Neurological Disorders, Huashan Hospital Fudan University Shanghai China
| | - Jia‐Ying Lu
- PET Center, National Clinical Research Center for Aging and Medicine, National Center for Neurological Disorders, Huashan Hospital Fudan University Shanghai China
| | - Yi‐Min Sun
- Department of Neurology, National Clinical Research Center for Aging and Medicine, National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital Fudan University Shanghai China
| | - Feng‐Tao Liu
- Department of Neurology, National Clinical Research Center for Aging and Medicine, National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital Fudan University Shanghai China
| | - Chuan‐Tao Zuo
- PET Center, National Clinical Research Center for Aging and Medicine, National Center for Neurological Disorders, Huashan Hospital Fudan University Shanghai China
| | - Jian Wang
- Department of Neurology, National Clinical Research Center for Aging and Medicine, National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital Fudan University Shanghai China
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Prasad S, Rajan A, Pasha SA, Mangalore S, Saini J, Ingalhalikar M, Pal PK. Abnormal structural connectivity in progressive supranuclear palsy-Richardson syndrome. Acta Neurol Scand 2021; 143:430-440. [PMID: 33175396 DOI: 10.1111/ane.13372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 11/04/2020] [Accepted: 11/04/2020] [Indexed: 01/14/2023]
Abstract
OBJECTIVES Progressive supranuclear palsy-Richardson syndrome (PSP-RS) is characterized by symmetrical parkinsonism with postural instability and frontal dysfunction. This study aims to use the whole brain structural connectome (SC) to gain insights into the underlying disconnectivity which may be implicated in the clinical features of PSP-RS. METHODS Sixteen patients of PSP-RS and 12 healthy controls were recruited. Disease severity was quantified using PSP rating scale (PSPRS), and mini-mental scale was applied to evaluate cognition. Thirty-two direction diffusion MRIs were acquired and used to compute the structural connectome of the whole brain using deterministic fiber tracking. Group analyses were performed at the edge-wise, nodal, and global levels. Age and gender were used as nuisance covariates for all the subsequent analyses, and FDR correction was applied. RESULTS Network-based statistics revealed a 34-edge network with significantly abnormal edge-wise connectivity in the patient group. Of these, 25 edges were cortical connections, of which 68% were frontal connections. Abnormal deep gray matter connections were predominantly comprised of connections between structures of the basal ganglia. The characteristic path length of the SC was lower in PSP-RS, and nodal analysis revealed abnormal degree, strength, local efficiency, betweenness centrality, and participation coefficient in several nodes. CONCLUSIONS Significant alterations in the structural connectivity of the whole brain connectome were observed in PSP-RS. The higher degree of abnormality observed in nodes belonging to the frontal lobe and basal ganglia substantiates the predominant frontal dysfunction and parkinsonism observed in PSP-RS. The findings of this study support the concept that PSP-RS may be a network-based disorder.
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Affiliation(s)
- Shweta Prasad
- Department of Clinical Neurosciences National Institute of Mental Health & Neurosciences Bangalore India
- Department of Neurology National Institute of Mental Health & Neurosciences Bangalore India
| | - Archith Rajan
- Symbiosis Center for Medical Image Analysis Symbiosis International University Pune India
- Symbiosis Institute of Technology Symbiosis International University Pune India
| | - Shaik Afsar Pasha
- Department of Neurology National Institute of Mental Health & Neurosciences Bangalore India
| | - Sandhya Mangalore
- Department of Neuroimaging & Interventional Radiology National Institute of Mental Health & Neurosciences Bangalore India
| | - Jitender Saini
- Department of Neuroimaging & Interventional Radiology National Institute of Mental Health & Neurosciences Bangalore India
| | - Madhura Ingalhalikar
- Symbiosis Center for Medical Image Analysis Symbiosis International University Pune India
- Symbiosis Institute of Technology Symbiosis International University Pune India
| | - Pramod Kumar Pal
- Department of Neurology National Institute of Mental Health & Neurosciences Bangalore India
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Nguyen TT, Cheng JS, Chen YL, Lin YC, Tsai CC, Lu CS, Weng YH, Wu YM, Hoang NT, Wang JJ. Fixel-Based Analysis of White Matter Degeneration in Patients With Progressive Supranuclear Palsy or Multiple System Atrophy, as Compared to Parkinson's Disease. Front Aging Neurosci 2021; 13:625874. [PMID: 33815089 PMCID: PMC8018443 DOI: 10.3389/fnagi.2021.625874] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 02/18/2021] [Indexed: 01/15/2023] Open
Abstract
Introduction: White matter degeneration may contribute to clinical symptoms of parkinsonism. Objective: We used fixel-based analysis (FBA) to compare the extent and patterns of white matter degeneration in different parkinsonian syndromes—including idiopathic Parkinson's disease (PD), multiple system atrophy (MSA), and progressive supranuclear palsy (PSP). Methods: This is a retrospective interpretation of prospectively acquired data of patients recruited in previous studies during 2008 and 2019. Diffusion-weighted images were acquired on a 3-Tesla scanner (diffusion weighting b = 1000 s/mm2–applied along either 64 or 30 non-collinear directions) from 53 patients with PD (men/women: 29/24; mean age: 65.06 ± 5.51 years), 47 with MSA (men/women: 20/27; mean age: 63.00 ± 7.19 years), and 50 with PSP men/women: 20/30; mean age: 65.96 ± 3.14 years). Non-parametric permutation tests were used to detect intergroup differences in fixel-related indices—including fiber density, fiber cross-section, and their combination. Results: Patterns of white matter degeneration were significantly different between PD and atypical parkinsonisms (MSA and PSP). Compared with patients with PD, those with MSA and PSP showed a more extensive white matter involvement—noticeably descending tracts from primary motor cortex to corona radiata and cerebral peduncle. Lesions of corpus callosum were specific to PSP and absent in both MSA and PD. Discussion: FBA identified specific patterns of white matter changes in MSA and PSP patients compared to PD. Our results proved the utility of FBA in evaluation of implied biological processes of white matter changes in parkinsonism. Our study set the stage for future applications of this technique in patients with parkinsonian syndromes.
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Affiliation(s)
- Thanh-Thao Nguyen
- Department of Radiology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Jur-Shan Cheng
- Clinical Informatics and Medical Statistics Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Yao-Liang Chen
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Keelung, Taiwan.,Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yu-Chun Lin
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Taiwan.,Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Chih-Chien Tsai
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Chin-Song Lu
- Professor Lu Neurological Clinic, Taoyuan, Taiwan.,Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taiwan.,Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Yi-Hsin Weng
- Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taiwan.,Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan.,School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Ming Wu
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Taiwan.,Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Ngoc-Thanh Hoang
- Department of Radiology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Jiun-Jie Wang
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Keelung, Taiwan.,Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan.,Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.,Medical Imaging Research Center, Institute for Radiological Research, Chang Gung University/Chang Gung Memorial Hospital, Linkou, Taiwan
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The effect of spatial resolution on the reproducibility of diffusion imaging when controlled signal to noise ratio. Biomed J 2019; 42:268-276. [PMID: 31627869 PMCID: PMC6818162 DOI: 10.1016/j.bj.2019.03.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 02/26/2019] [Accepted: 03/11/2019] [Indexed: 12/28/2022] Open
Abstract
Background The purpose of the study is to evaluate the reproducibility and repeatability of the compartmental diffusion measurement. Methods Two identical whipping cream phantoms and two healthy Sprague–Dawley rats were scanned on a 7T MR scanner, each repeated for three times. Diffusion weighted images were acquired along 30 non-collinear gradient directions, each with four b-values of 750, 1500, 2250 and 3000 s/mm2. Slice thickness and field of view were used to create different combinations of voxel sizes, varied between 1.210 and 2.366 mm3 in phantom and 0.200–0.303 mm3 in rat brains. Multiple averages were used to achieve a controlled signal to noise ratio. Results Diffusion imaging showed good stability throughout the range of voxel sizes acquired from either the cream phantom or the rat, when the signal to noise ratio is controlled. The reproducibility analysis showed the within-subject coefficient of variation varied between 0.88% and 6.99% for phantom and 0.69%–6.19% for rat. Diffusion imaging is stable among different voxel sizes in 3 aspects: A. from both compartments in phantom and in the rat; B. in measurement of diffusivity and kurtosis and C. along axial, radial and averaged in all directions. Conclusion Diffusion imaging in a heterogeneous but isotropic phantom and in vivo is consistent within the range of spatial resolution in preclinical use and when the signal to noise ratio is fixed. The result is reproducible for repeated measurements.
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Abos A, Segura B, Baggio HC, Campabadal A, Uribe C, Garrido A, Camara A, Muñoz E, Valldeoriola F, Marti MJ, Junque C, Compta Y. Disrupted structural connectivity of fronto-deep gray matter pathways in progressive supranuclear palsy. NEUROIMAGE-CLINICAL 2019; 23:101899. [PMID: 31229940 PMCID: PMC6593210 DOI: 10.1016/j.nicl.2019.101899] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/09/2019] [Accepted: 06/13/2019] [Indexed: 01/04/2023]
Abstract
Background Structural connectivity is a promising methodology to detect patterns of neural network dysfunction in neurodegenerative diseases. This approach has not been tested in progressive supranuclear palsy (PSP). Objectives The aim of this study is reconstructing the structural connectome to characterize and detect the pathways of degeneration in PSP patients compared with healthy controls and their correlation with clinical features. The second objective is to assess the potential of structural connectivity measures to distinguish between PSP patients and healthy controls at the single-subject level. Methods Twenty healthy controls and 19 PSP patients underwent diffusion-weighted MRI with a 3T scanner. Structural connectivity, represented by number of streamlines, was derived from probabilistic tractography. Global and local network metrics were calculated based on graph theory. Results Reduced numbers of streamlines were predominantly found in connections between frontal areas and deep gray matter (DGM) structures in PSP compared with controls. Significant changes in structural connectivity correlated with clinical features in PSP patients. An abnormal small-world architecture was detected in the subnetwork comprising the frontal lobe and DGM structures in PSP patients. The classification procedure achieved an overall accuracy of 82.23% with 94.74% sensitivity and 70% specificity. Conclusion Our findings suggest that modelling the brain as a structural connectome is a useful method to detect changes in the organization and topology of white matter tracts in PSP patients. Secondly, measures of structural connectivity have the potential to correctly discriminate between PSP patients and healthy controls. Reduced structural connectivity in PSP patients compared with healthy controls Connectivity reductions in fronto-DGM tracts correlate with PSPRS and FAB scores PSP patients present abnormal small-world architecture in the fronto-DGM network.
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Affiliation(s)
- Alexandra Abos
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona.Barcelona, Catalonia, Spain.
| | - Barbara Segura
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona.Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona. Barcelona, Catalonia, Spain.
| | - Hugo C Baggio
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona.Barcelona, Catalonia, Spain.
| | - Anna Campabadal
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona.Barcelona, Catalonia, Spain.
| | - Carme Uribe
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona.Barcelona, Catalonia, Spain.
| | - Alicia Garrido
- Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
| | - Ana Camara
- Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain.
| | - Esteban Muñoz
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona. Barcelona, Catalonia, Spain; Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain.
| | - Francesc Valldeoriola
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona. Barcelona, Catalonia, Spain; Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain.
| | - Maria Jose Marti
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona. Barcelona, Catalonia, Spain; Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain.
| | - Carme Junque
- Medical Psychology Unit, Department of Medicine, Institute of Neuroscience, University of Barcelona.Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona. Barcelona, Catalonia, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain.
| | - Yaroslau Compta
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona. Barcelona, Catalonia, Spain; Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institute of Neuroscience, University of Barcelona, Barcelona, Catalonia, Spain; Institute of Biomedical Research August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain.
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Latorre A, Rocchi L, Berardelli A, Bhatia KP, Rothwell JC. The interindividual variability of transcranial magnetic stimulation effects: Implications for diagnostic use in movement disorders. Mov Disord 2019; 34:936-949. [DOI: 10.1002/mds.27736] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 05/09/2019] [Accepted: 05/16/2019] [Indexed: 11/08/2022] Open
Affiliation(s)
- Anna Latorre
- Department of Clinical and Movement NeurosciencesQueen Square Institute of Neurology University College London London United Kingdom
- Department of Neurology and Psychiatry, SapienzaUniversity of Rome Rome Italy
| | - Lorenzo Rocchi
- Department of Clinical and Movement NeurosciencesQueen Square Institute of Neurology University College London London United Kingdom
| | - Alfredo Berardelli
- Department of Neurology and Psychiatry, SapienzaUniversity of Rome Rome Italy
- Istituto di Ricovero e Cura a Carattere Scientifico Neuromed Pozzilli Isernia Italy
| | - Kailash P. Bhatia
- Department of Clinical and Movement NeurosciencesQueen Square Institute of Neurology University College London London United Kingdom
| | - John C. Rothwell
- Department of Clinical and Movement NeurosciencesQueen Square Institute of Neurology University College London London United Kingdom
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De Micco R, Russo A, Tessitore A. Structural MRI in Idiopathic Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 141:405-438. [PMID: 30314605 DOI: 10.1016/bs.irn.2018.08.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
Among modern neuroimaging modalities, magnetic resonance imaging (MRI) is a widely available, non-invasive, and cost-effective method to detect structural and functional abnormalities related to neurodegenerative disorders. In the last decades, MRI have been widely implemented to support PD diagnosis as well as to provide further insights into motor and non-motor symptoms pathophysiology, complications and treatment-related effects. Different aspects of the brain morphology and function may be derived from a single scan, by applying different analytic approaches. Biomarkers of neurodegeneration as well as tissue microstructural changes may be extracted from structural MRI techniques. In this chapter, we analyze the role of structural imaging to differentiate PD patients from controls and to define neural substrates of motor and non-motor PD symptoms. Evidence collected in the premotor PD phase will be also critically discussed. White matter as well as gray matter integrity imaging studies has been reviewed, aiming to highlight points of strength and limits to their potential application in clinical settings.
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Affiliation(s)
- Rosa De Micco
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy; MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Antonio Russo
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy; MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Alessandro Tessitore
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy; MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Napoli, Italy.
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Pandey AK, Ardekani BA, Kamarajan C, Zhang J, Chorlian DB, Byrne KNH, Pandey G, Meyers JL, Kinreich S, Stimus A, Porjesz B. Lower Prefrontal and Hippocampal Volume and Diffusion Tensor Imaging Differences Reflect Structural and Functional Abnormalities in Abstinent Individuals with Alcohol Use Disorder. Alcohol Clin Exp Res 2018; 42:1883-1896. [PMID: 30118142 DOI: 10.1111/acer.13854] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 07/25/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND Alcohol use disorder (AUD) is known to have adverse effects on brain structure and function. Multimodal assessments investigating volumetric, diffusion, and cognitive characteristics may facilitate understanding of the consequences of long-term alcohol use on brain circuitry, their structural impairment patterns, and their impact on cognitive function in AUD. METHODS Voxel- and surface-based volumetric estimations, diffusion tensor imaging (DTI), and neuropsychological tests were performed on 60 individuals: 30 abstinent individuals with AUD (DSM-IV) and 30 healthy controls. Group differences in the volumes of cortical and subcortical regions, fractional anisotropy (FA), axial and radial diffusivities (AD and RD, respectively), and performance on neuropsychological tests were analyzed, and the relationship among significantly different measures was assessed using canonical correlation. RESULTS AUD participants had significantly smaller volumes in left pars orbitalis, right medial orbitofrontal, right caudal middle frontal, and bilateral hippocampal regions, lower FA in 9 white matter (WM) regions, and higher FA in left thalamus, compared to controls. In AUD, lower FA in 6 of 9 WM regions was due to higher RD and due to lower AD in the left external capsule. AUD participants scored lower on problem-solving ability, visuospatial memory span, and working memory. Positive correlations of prefrontal cortical, left hippocampal volumes, and FA in 4 WM regions with visuospatial memory performance and negative correlation with lower problem-solving ability were observed. Significant positive correlation between age and FA was observed in bilateral putamen. CONCLUSIONS Findings showed specific structural brain abnormalities to be associated with visuospatial memory and problem-solving ability-related impairments observed in AUD. Higher RD in 6 WM regions suggests demyelination, and lower AD in left external capsule suggests axonal loss in AUD. The positive correlation between FA and age in bilateral putamen may reflect accumulation of iron depositions with increasing age.
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Affiliation(s)
- Ashwini Kumar Pandey
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York
| | - Babak Assai Ardekani
- Computational Neuroimaging Laboratories of the Center for Biomedical Imaging and Neuromodulation (C-BIN), The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York
| | - Chella Kamarajan
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York
| | - Jian Zhang
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York
| | - David Balin Chorlian
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York
| | - Kelly Nicole-Helen Byrne
- Computational Neuroimaging Laboratories of the Center for Biomedical Imaging and Neuromodulation (C-BIN), The Nathan S. Kline Institute for Psychiatric Research, Orangeburg, New York
| | - Gayathri Pandey
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York
| | - Jacquelyn Leigh Meyers
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York
| | - Sivan Kinreich
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York
| | - Arthur Stimus
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York
| | - Bernice Porjesz
- Henri Begleiter Neurodynamics Laboratory, Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York
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12
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Abnormalities of white and grey matter in early multiple system atrophy: comparison of parkinsonian and cerebellar variants. Eur Radiol 2018; 29:716-724. [DOI: 10.1007/s00330-018-5594-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 05/21/2018] [Accepted: 06/05/2018] [Indexed: 11/26/2022]
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13
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Ofori E, Krismer F, Burciu RG, Pasternak O, McCracken JL, Lewis MM, Du G, McFarland NR, Okun MS, Poewe W, Mueller C, Gizewski ER, Schocke M, Kremser C, Li H, Huang X, Seppi K, Vaillancourt DE. Free water improves detection of changes in the substantia nigra in parkinsonism: A multisite study. Mov Disord 2017; 32:1457-1464. [PMID: 28714593 DOI: 10.1002/mds.27100] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 05/19/2017] [Accepted: 06/11/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Imaging markers that are sensitive to parkinsonism across multiple sites are critically needed for clinical trials. The objective of this study was to evaluate changes in the substantia nigra using single- and bi-tensor models of diffusion magnetic resonance imaging in PD, MSA, and PSP. METHODS The study cohort (n = 425) included 107 healthy controls and 184 PD, 63 MSA, and 71 PSP patients from 3 movement disorder centers. Bi-tensor free water, free-water-corrected fractional anisotropy, free-water-corrected mean diffusivity, single-tensor fractional anisotropy, and single-tensor mean diffusivity were computed for the anterior and posterior substantia nigra. Correlations were computed between diffusion MRI measures and clinical measures. RESULTS In the posterior substantia nigra, free water was greater for PSP than MSA and PD patients and controls. PD and MSA both had greater free water than controls. Free-water-corrected fractional anisotropy values were greater for PSP patents than for controls and PD patients. PSP and MSA patient single-tensor mean diffusivity values were greater than controls, and single-tensor fractional anisotropy values were lower for PSP patients than for healthy controls. The parkinsonism effect size for free water was 0.145 in the posterior substantia nigra and 0.072 for single-tensor mean diffusivity. The direction of correlations between single-tensor mean diffusivity and free-water values and clinical scores was similar at each site. CONCLUSIONS Free-water values in the posterior substantia nigra provide a consistent pattern of findings across patients with PD, MSA, and PSP in a large cohort across 3 sites. Free water in the posterior substantia nigra relates to clinical measures of motor and cognitive symptoms in a large cohort of parkinsonism. © 2017 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Edward Ofori
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, USA
| | - Florian Krismer
- Department of Neuroradiology, Medical University Innsbruck, Innsbruck, Austria
| | - Roxana G Burciu
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, USA
| | - Ofer Pasternak
- Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Johanna L McCracken
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, USA
| | - Mechelle M Lewis
- Department of Neurology, Penn State - Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA.,Department of Pharmacology, Penn State - Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Guangwei Du
- Department of Neurology, Penn State - Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Nikolaus R McFarland
- Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, Florida, USA.,Department of Neurology, University of Florida, Gainesville, Florida, USA
| | - Michael S Okun
- Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, Florida, USA.,Department of Neurology, University of Florida, Gainesville, Florida, USA.,Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Werner Poewe
- Department of Neuroradiology, Medical University Innsbruck, Innsbruck, Austria.,Neuroimaging Research Core Facility, Medical University Innsbruck, Innsbruck, Austria
| | - Christoph Mueller
- Department of Neuroradiology, Medical University Innsbruck, Innsbruck, Austria
| | - Elke R Gizewski
- Neuroimaging Research Core Facility, Medical University Innsbruck, Innsbruck, Austria.,Department of Neuroradiology, Medical University Innsbruck, Innsbruck, Austria
| | - Michael Schocke
- Neuroimaging Research Core Facility, Medical University Innsbruck, Innsbruck, Austria.,Department of Neuroradiology, Medical University Innsbruck, Innsbruck, Austria
| | - Christian Kremser
- Neuroimaging Research Core Facility, Medical University Innsbruck, Innsbruck, Austria.,Department of Neuroradiology, Medical University Innsbruck, Innsbruck, Austria
| | - Hong Li
- Department of Public Health Sciences, Medical College of South Carolina, Charleston, South Carolina, USA
| | - Xuemei Huang
- Department of Neurology, Penn State - Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA.,Department of Pharmacology, Penn State - Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA.,Departments of Neurosurgery, Radiology, and Kinesiology, Penn State - Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Klaus Seppi
- Department of Neuroradiology, Medical University Innsbruck, Innsbruck, Austria
| | - David E Vaillancourt
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, USA.,Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, Florida, USA.,Department of Biomedical Engineering, University of Florida, Gainesville, Florida, USA
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14
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Ito K, Ohtsuka C, Yoshioka K, Kameda H, Yokosawa S, Sato R, Terayama Y, Sasaki M. Differential diagnosis of parkinsonism by a combined use of diffusion kurtosis imaging and quantitative susceptibility mapping. Neuroradiology 2017; 59:759-769. [PMID: 28689259 DOI: 10.1007/s00234-017-1870-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 06/16/2017] [Indexed: 01/23/2023]
Abstract
PURPOSE We investigated whether diffusion kurtosis imaging (DKI) and quantitative susceptibility mapping (QSM) could detect pathological changes that occur in Parkinson's disease (PD), multiple system atrophy with predominant parkinsonism (MSA-P) or predominant cerebellar ataxia (MSA-C), and progressive supranuclear palsy syndrome (PSPS) and thus be used for differential diagnosis that is often difficult. METHODS Seventy patients (41 with PD, 6 with MSA-P, 7 with MSA-C, 16 with PSPS) and 20 healthy controls were examined using a 3.0 T MRI scanner. From DKI and QSM data, we automatically obtained mean kurtosis (MK), fractional anisotropy (FA), and mean diffusivity (MD) values of the midbrain tegmentum (MBT), pontine crossing tract (PCT), and superior/middle cerebellar peduncles (CPs), which were used to calculate diffusion MBT/PCT ratios (dMPRs) and diffusion superior/middle CP ratios (dCPRs), as well as MS (magnetic susceptibility) values of the anterior/posterior putamen (PUa and PUp) and globus pallidus (GP). RESULTS dMPRs of MK were significantly decreased in PSPS and increased in MSA-C compared with the other groups, while dCPRs of MK showed significant differences only between MSA-C and PD, PSPS, or control. MS values were significantly increased in the PUp of MSA-P and in the PUa and GP of PSPS compared with those in PD. The combined use of MK-dMPR and MS-PUp showed sensitivities of 83-100% and specificities of 81-100% for discriminating among the disease groups, respectively. CONCLUSION A quantitative assessment using DKI and QSM analyses, particularly MK-dMPR and MS-PUp values, can readily identify patients with parkinsonism.
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Affiliation(s)
- Kenji Ito
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, 2-1-1 Nishitokuta, Yahaba, Iwate, 028-3694, Japan.
| | - Chigumi Ohtsuka
- Department of Neurology and Gerontology, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, Japan
| | - Kunihiro Yoshioka
- Department of Radiology, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, Japan
| | - Hiroyuki Kameda
- Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, N14 W5, Kita-ku, Sapporo, Hokkaido, Japan
| | - Suguru Yokosawa
- Research & Development Group, Hitachi, Ltd., 1-280 Higashi-Koigakubo, Kokubunji, Tokyo, Japan
| | - Ryota Sato
- Research & Development Group, Hitachi, Ltd., 1-280 Higashi-Koigakubo, Kokubunji, Tokyo, Japan
| | - Yasuo Terayama
- Department of Neurology and Gerontology, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, Japan
| | - Makoto Sasaki
- Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, 2-1-1 Nishitokuta, Yahaba, Iwate, 028-3694, Japan
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15
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Whitwell JL, Höglinger GU, Antonini A, Bordelon Y, Boxer AL, Colosimo C, van Eimeren T, Golbe LI, Kassubek J, Kurz C, Litvan I, Pantelyat A, Rabinovici G, Respondek G, Rominger A, Rowe JB, Stamelou M, Josephs KA. Radiological biomarkers for diagnosis in PSP: Where are we and where do we need to be? Mov Disord 2017; 32:955-971. [PMID: 28500751 PMCID: PMC5511762 DOI: 10.1002/mds.27038] [Citation(s) in RCA: 149] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 04/11/2017] [Accepted: 04/13/2017] [Indexed: 12/11/2022] Open
Abstract
PSP is a pathologically defined neurodegenerative tauopathy with a variety of clinical presentations including typical Richardson's syndrome and other variant PSP syndromes. A large body of neuroimaging research has been conducted over the past two decades, with many studies proposing different structural MRI and molecular PET/SPECT biomarkers for PSP. These include measures of brainstem, cortical and striatal atrophy, diffusion weighted and diffusion tensor imaging abnormalities, [18F] fluorodeoxyglucose PET hypometabolism, reductions in striatal dopamine imaging and, most recently, PET imaging with ligands that bind to tau. Our aim was to critically evaluate the degree to which structural and molecular neuroimaging metrics fulfill criteria for diagnostic biomarkers of PSP. We queried the PubMed, Cochrane, Medline, and PSYCInfo databases for original research articles published in English over the past 20 years using postmortem diagnosis or the NINDS-SPSP criteria as the diagnostic standard from 1996 to 2016. We define a five-level theoretical construct for the utility of neuroimaging biomarkers in PSP, with level 1 representing group-level findings, level 2 representing biomarkers with demonstrable individual-level diagnostic utility, level 3 representing biomarkers for early disease, level 4 representing surrogate biomarkers of PSP pathology, and level 5 representing definitive PSP biomarkers of PSP pathology. We discuss the degree to which each of the currently available biomarkers fit into this theoretical construct, consider the role of biomarkers in the diagnosis of Richardson's syndrome, variant PSP syndromes and autopsy confirmed PSP, and emphasize current shortfalls in the field. © 2017 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
| | - Günter U. Höglinger
- Department of Neurology, Technische Universität München, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Germany
| | - Angelo Antonini
- Parkinson and Movement Disorder Unit, IRCCS Hospital San Camillo, Venice and Department of Neurosciences (DNS), Padova University, Padova, Italy
| | - Yvette Bordelon
- Department of Neurology, University of California, Los Angeles, CA, USA
| | - Adam L. Boxer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Carlo Colosimo
- Department of Neurology, Santa Maria University Hospital, Terni, Italy
| | - Thilo van Eimeren
- German Center for Neurodegenerative Diseases (DZNE), Germany
- Department of Nuclear Medicine, University of Cologne, Cologne, Germany
| | - Lawrence I. Golbe
- Department of Neurology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Jan Kassubek
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Carolin Kurz
- Psychiatrische Klinik, Ludwigs-Maximilians-Universität, München, Germany
| | - Irene Litvan
- Department of Neurology, University of California, San Diego, CA, USA
| | | | - Gil Rabinovici
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, USA
| | - Gesine Respondek
- Department of Neurology, Technische Universität München, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Germany
| | - Axel Rominger
- Deptartment of Nuclear Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - James B. Rowe
- Department of Clinical Neurosciences, Cambridge University, Cambridge, UK
| | - Maria Stamelou
- Second Department of Neurology, Attikon University Hospital, University of Athens, Greece; Philipps University, Marburg, Germany; Movement Disorders Dept., HYGEIA Hospital, Athens, Greece
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16
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Advanced structural neuroimaging in progressive supranuclear palsy: Where do we stand? Parkinsonism Relat Disord 2017; 36:19-32. [DOI: 10.1016/j.parkreldis.2016.12.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 12/01/2016] [Accepted: 12/23/2016] [Indexed: 12/11/2022]
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17
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Nicoletti G, Caligiuri ME, Cherubini A, Morelli M, Novellino F, Arabia G, Salsone M, Quattrone A. A Fully Automated, Atlas-Based Approach for Superior Cerebellar Peduncle Evaluation in Progressive Supranuclear Palsy Phenotypes. AJNR Am J Neuroradiol 2016; 38:523-530. [PMID: 28034996 DOI: 10.3174/ajnr.a5048] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 10/24/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND PURPOSE The superior cerebellar peduncle is damaged in progressive supranuclear palsy. However, alterations differ between progressive supranuclear palsy with Richardson syndrome and progressive supranuclear palsy-parkinsonism. In this study, we propose an automated tool for superior cerebellar peduncle integrity assessment and test its performance in patients with progressive supranuclear palsy with Richardson syndrome, progressive supranuclear palsy-parkinsonism, Parkinson disease, and healthy controls. MATERIALS AND METHODS Structural and diffusion MRI was performed in 21 patients with progressive supranuclear palsy with Richardson syndrome, 9 with progressive supranuclear palsy-parkinsonism, 20 with Parkinson disease, and 30 healthy subjects. In a fully automated pipeline, the left and right superior cerebellar peduncles were first identified on MR imaging by using a tractography-based atlas of white matter tracts; subsequently, volume, mean diffusivity, and fractional anisotropy were extracted from superior cerebellar peduncles. These measures were compared across groups, and their discriminative power in differentiating patients was evaluated in a linear discriminant analysis. RESULTS Compared with those with Parkinson disease and controls, patients with progressive supranuclear palsy with Richardson syndrome showed alterations of all superior cerebellar peduncle metrics (decreased volume and fractional anisotropy, increased mean diffusivity). Patients with progressive supranuclear palsy-parkinsonism had smaller volumes than those with Parkinson disease and controls and lower fractional anisotropy than those with Parkinson disease. Patients with progressive supranuclear palsy with Richardson syndrome had significantly altered fractional anisotropy and mean diffusivity in the left superior cerebellar peduncle compared with those with progressive supranuclear palsy-parkinsonism. Discriminant analysis with the sole use of significant variables separated progressive supranuclear palsy-parkinsonism from progressive supranuclear palsy with Richardson syndrome with 70% accuracy and progressive supranuclear palsy-parkinsonism from Parkinson disease with 74% accuracy. CONCLUSIONS We demonstrate the feasibility of an automated approach for extracting multimodal MR imaging metrics from the superior cerebellar peduncle in healthy subjects and patients with parkinsonian. We provide evidence that structural and diffusion measures of the superior cerebellar peduncle might be valuable for computer-aided diagnosis of progressive supranuclear palsy subtypes and for differentiating patients with progressive supranuclear palsy-parkinsonism from with those with Parkinson disease.
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Affiliation(s)
- G Nicoletti
- From the Institute of Bioimaging and Molecular Physiology (G.N., M.E.C., A.C., F.N., M.S., A.Q.), National Research Council, Catanzaro, Italy
| | - M E Caligiuri
- From the Institute of Bioimaging and Molecular Physiology (G.N., M.E.C., A.C., F.N., M.S., A.Q.), National Research Council, Catanzaro, Italy
| | - A Cherubini
- From the Institute of Bioimaging and Molecular Physiology (G.N., M.E.C., A.C., F.N., M.S., A.Q.), National Research Council, Catanzaro, Italy
| | - M Morelli
- Institute of Neurology (M.M., G.A., A.Q.), University "Magna Graecia", Catanzaro, Italy
| | - F Novellino
- From the Institute of Bioimaging and Molecular Physiology (G.N., M.E.C., A.C., F.N., M.S., A.Q.), National Research Council, Catanzaro, Italy
| | - G Arabia
- Institute of Neurology (M.M., G.A., A.Q.), University "Magna Graecia", Catanzaro, Italy
| | - M Salsone
- From the Institute of Bioimaging and Molecular Physiology (G.N., M.E.C., A.C., F.N., M.S., A.Q.), National Research Council, Catanzaro, Italy
| | - A Quattrone
- From the Institute of Bioimaging and Molecular Physiology (G.N., M.E.C., A.C., F.N., M.S., A.Q.), National Research Council, Catanzaro, Italy.,Institute of Neurology (M.M., G.A., A.Q.), University "Magna Graecia", Catanzaro, Italy
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18
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Lu CS, Ng SH, Weng YH, Cheng JS, Lin WY, Wai YY, Chen YL, Wang JJ. Alterations of diffusion tensor MRI parameters in the brains of patients with Parkinson's disease compared with normal brains: possible diagnostic use. Eur Radiol 2016; 26:3978-3988. [PMID: 26945764 DOI: 10.1007/s00330-016-4232-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 01/12/2016] [Accepted: 01/20/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To investigate the diagnostic performance of diffusion tensor imaging in patients with Parkinson's disease (PD). METHODS We examined a total of 126 PD patients (68 males/58 females, mean age: 62.0 ±7.6 years) and 91 healthy controls (43 males/48 females, mean age: 59.8 ±7.2 years). Images were acquired on a 3 Tesla magnetic resonance scanner. The Camino software was used to normalize and parcellate diffusion-weighted images into 90 cerebral regions based on the automatic anatomical labelling template. The minimum, median, and maximum values of the mean/radial/axial diffusivity/fractional anisotropy were determined. The diagnostic performance was assessed by receiver operating characteristic analysis. The associations of imaging parameters with disease severity were tested using Pearson's correlation coefficients after adjustment for disease duration. RESULTS Compared with healthy controls, PD patients showed increased diffusivity in multiple cortical regions that extended beyond the basal ganglia. An area under curve of 85 % was identified for the maximum values of mean diffusivity in the ipsilateral middle temporal gyrus. The most significant intergroup difference was 26.8 % for the ipsilateral inferior parietal gyrus. CONCLUSION The measurement of water diffusion from the parcellated cortex may be clinically useful for the assessment of PD patients. KEY POINTS • Increased diffusivity was identified in multiple cortical regions of Parkinson's disease patients. • The area under the receiver operating curve was 85 % in the middle temporal gyrus. • The ipsilateral inferior parietal gyrus showed the most significant change.
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Affiliation(s)
- Chin-Song Lu
- Division of Movement Disorders,Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Neuroscience Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shu-Hang Ng
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, 259 WenHua 1st Road, Taoyuan County, 333, Taiwan
| | - Yi-Hsin Weng
- Division of Movement Disorders,Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Neuroscience Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jur-Shan Cheng
- Clinical Informatics and Medical Statistics Research Center,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wey-Yil Lin
- Division of Movement Disorders,Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Neuroscience Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yau-Yau Wai
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Yao-Liang Chen
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Taiwan
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Jiun-Jie Wang
- Neuroscience Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Taiwan.
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, 259 WenHua 1st Road, Taoyuan County, 333, Taiwan.
- Medical Imaging Research Center, Institute for Radiological Research, Chang Gung University / Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan.
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19
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Zanigni S, Calandra-Buonaura G, Manners DN, Testa C, Gibertoni D, Evangelisti S, Sambati L, Guarino M, De Massis P, Gramegna LL, Bianchini C, Rucci P, Cortelli P, Lodi R, Tonon C. Accuracy of MR markers for differentiating Progressive Supranuclear Palsy from Parkinson's disease. NEUROIMAGE-CLINICAL 2016; 11:736-742. [PMID: 27330973 PMCID: PMC4908307 DOI: 10.1016/j.nicl.2016.05.016] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 05/17/2016] [Accepted: 05/27/2016] [Indexed: 11/30/2022]
Abstract
Background Advanced brain MR techniques are useful tools for differentiating Progressive Supranuclear Palsy from Parkinson's disease, although time-consuming and unlikely to be used all together in routine clinical work. We aimed to compare the diagnostic accuracy of quantitative morphometric, volumetric and DTI metrics for differentiating Progressive Supranuclear Palsy-Richardson's Syndrome from Parkinson's disease. Methods 23 Progressive Supranuclear Palsy-Richardson's Syndrome and 42 Parkinson's disease patients underwent a standardized 1.5T brain MR protocol comprising high-resolution T1W1 and DTI sequences. Brainstem and cerebellar peduncles morphometry, automated volumetric analysis of brain deep gray matter and DTI metric analyses of specific brain structures were carried out. We determined diagnostic accuracy, sensitivity and specificity of MR-markers with respect to the clinical diagnosis by using univariate receiver operating characteristics curve analyses. Age-adjusted multivariate receiver operating characteristics analyses were then conducted including only MR-markers with a sensitivity and specificity exceeding 80%. Results Morphometric markers (midbrain area, pons to midbrain area ratio and MR Parkinsonism Index), DTI parameters (infratentorial structures) and volumetric analysis (thalamus, putamen and pallidus nuclei) presented moderate to high diagnostic accuracy in discriminating Progressive Supranuclear Palsy-Richardson's Syndrome from Parkinson's disease, with midbrain area showing the highest diagnostic accuracy (99%) (mean ± standard deviation: 75.87 ± 16.95 mm2vs 132.45 ± 20.94 mm2, respectively; p < 0.001). Conclusion Although several quantitative brain MR markers provided high diagnostic accuracy in differentiating Progressive Supranuclear Palsy-Richardson's Syndrome from Parkinson's disease, the morphometric assessment of midbrain area is the best single diagnostic marker and should be routinely included in the neuroradiological work-up of parkinsonian patients. We compared quantitative brain MR markers accuracy to differentiate advanced stages of PSP-RS from PD. Quantitative morphometric, DTI and volumetric data showed moderate-high accuracies. Midbrain area alone best discriminated advanced PSP-RS from PD (99%). Midbrain area evaluation should be added to brain MR protocols for parkinsonisms.
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Key Words
- AUC, area under the curve
- DTI
- FA, Fractional Anisotropy
- MCP, middle cerebellar peduncle
- MD, Mean Diffusivity
- MRI
- MRPI, MR Parkinsonism Index
- Morphometry
- P/M, pons to midbrain ratio
- PD, idiopathic Parkinson's disease
- PSP-RS, Progressive Supranuclear Palsy-Richardson's Syndrome
- Parkinson's disease
- Progressive Supranuclear Palsy
- ROC, receiver operating characteristics
- SCP, superior cerebellar peduncle
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Affiliation(s)
- Stefano Zanigni
- Functional MR Unit, Policlinico S. Orsola - Malpighi, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Giovanna Calandra-Buonaura
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - David Neil Manners
- Functional MR Unit, Policlinico S. Orsola - Malpighi, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Claudia Testa
- Functional MR Unit, Policlinico S. Orsola - Malpighi, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Dino Gibertoni
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Unit of Hygiene and Biostatistics, University of Bologna, Italy
| | - Stefania Evangelisti
- Functional MR Unit, Policlinico S. Orsola - Malpighi, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Luisa Sambati
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Maria Guarino
- Neurology Unit, Policlinico S. Orsola - Malpighi, Bologna, Italy
| | | | - Laura Ludovica Gramegna
- Functional MR Unit, Policlinico S. Orsola - Malpighi, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Claudio Bianchini
- Functional MR Unit, Policlinico S. Orsola - Malpighi, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Paola Rucci
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Unit of Hygiene and Biostatistics, University of Bologna, Italy
| | - Pietro Cortelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Raffaele Lodi
- Functional MR Unit, Policlinico S. Orsola - Malpighi, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
| | - Caterina Tonon
- Functional MR Unit, Policlinico S. Orsola - Malpighi, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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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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Surova Y, Nilsson M, Lätt J, Lampinen B, Lindberg O, Hall S, Widner H, Nilsson C, van Westen D, Hansson O. Disease-specific structural changes in thalamus and dentatorubrothalamic tract in progressive supranuclear palsy. Neuroradiology 2015; 57:1079-91. [PMID: 26253801 PMCID: PMC4626534 DOI: 10.1007/s00234-015-1563-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 07/12/2015] [Indexed: 11/26/2022]
Abstract
Introduction The aim of this study is to identify disease-specific changes of the thalamus, basal ganglia, pons, and midbrain in patients with progressive supranuclear palsy (PSP), Parkinson’s disease (PD), and multiple system atrophy with predominant parkinsonism (MSA-P) using diffusion tensor imaging and volumetric analysis. Methods MRI diffusion and volumetric data were acquired in a derivation of 30 controls and 8 patients with PSP and a validation cohort comprised of controls (n = 21) and patients with PSP (n = 27), PD (n = 10), and MSA-P (n = 11). Analysis was performed using regions of interest (ROI), tract-based spatial statistic (TBSS), and tractography and results compared between diagnostic groups. Results In the derivation cohort, we observed increased mean diffusivity (MD) in the thalamus, superior cerebellar peduncle, and the midbrain in PSP compared to controls. Furthermore, volumetric analysis showed reduced thalamic volumes in PSP. In the validation cohort, the observations of increased MD were replicated by ROI-based analysis and in the thalamus by TBSS-based analysis. Such differences were not found for patients with PD in any of the cohorts. Tractography of the dentatorubrothalamic tract (DRTT) showed increased MD in PSP patients from both cohorts compared to controls and in the validation cohort in PSP compared to PD and MSA patients. Increased MD in the thalamus and along the DRTT correlated with disease stage and motor function in PSP. Conclusion Patients with PSP, but not PD or MSA-P, exhibit signs of structural abnormalities in the thalamus and in the DRTT. These changes are associated with disease stage and impaired motor function.
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Affiliation(s)
- Yulia Surova
- Department of Clinical Sciences, Lund University, Lund, Sweden.
- Department of Neurology, Skåne University Hospital, 221 85, Lund, Sweden.
| | - Markus Nilsson
- Lund University Bioimaging Center, Lund University, Lund, Sweden
| | - Jimmy Lätt
- Center for Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
| | - Björn Lampinen
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
| | - Olof Lindberg
- Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
| | - Sara Hall
- Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Neurology, Skåne University Hospital, 221 85, Lund, Sweden
| | - Håkan Widner
- Department of Clinical Sciences, Lund University, Lund, Sweden
- Department of Neurology, Skåne University Hospital, 221 85, Lund, Sweden
| | - Christer Nilsson
- Department of Neurology, Skåne University Hospital, 221 85, Lund, Sweden
- Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
| | - Danielle van Westen
- Department of Clinical Sciences, Lund University, Lund, Sweden
- Center for Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
| | - Oskar Hansson
- Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
- Memory Clinic, Skåne University Hospital, Lund, Sweden
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Neuroimaging evidence of gray and white matter damage and clinical correlates in progressive supranuclear palsy. J Neurol 2015; 262:1850-8. [PMID: 25980906 DOI: 10.1007/s00415-015-7779-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 05/06/2015] [Accepted: 05/07/2015] [Indexed: 12/31/2022]
Abstract
To evaluate gray matter (GM) and white matter (WM) abnormalities and their clinical correlates in patients with progressive supranuclear palsy (PSP). Sixteen PSP patients and sixteen age-matched healthy subjects underwent a clinical evaluation and multimodal magnetic resonance imaging, including three-dimensional T1-weighted imaging and diffusion tensor imaging (DTI). Volumetric and DTI analyses were computed using SPM and FSL tools. PSP patients showed GM volume decrease, involving the frontal cortex, putamen, pallidum, thalamus and accumbens nucleus, cerebellum, and brainstem. Additionally, they had widespread changes in WM bundles, mainly affecting cerebellar peduncles, thalamic radiations, corticospinal tracts, corpus callosum, and longitudinal fasciculi. GM volumes did not correlate with WM abnormalities. DTI indices of WM damage, but not GM volumes, correlated with clinical scores of disease severity and cognitive impairment. The neurodegenerative changes that occur in PSP involve both GM and WM structures and develop concurrently though independently. WM damage in PSP correlates with clinical scores of disease severity and cognitive impairment, thus providing further insight into the pathophysiology of the disease.
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Conventional 3T brain MRI and diffusion tensor imaging in the diagnostic workup of early stage parkinsonism. Neuroradiology 2015; 57:655-69. [PMID: 25845807 PMCID: PMC4495265 DOI: 10.1007/s00234-015-1515-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 03/13/2015] [Indexed: 11/17/2022]
Abstract
Introduction The aim of this study is to evaluate whether the diagnostic accuracy of 3 T brain MRI is improved by region of interest (ROI) measures of diffusion tensor imaging (DTI), to differentiate between neurodegenerative atypical parkinsonism (AP) and Parkinson’s disease (PD) in early stage parkinsonism. Methods We performed a prospective observational cohort study of 60 patients presenting with early stage parkinsonism and initial uncertain diagnosis. At baseline, patients underwent a 3 T brain MRI including DTI. After clinical follow-up (mean 28.3 months), diagnoses could be made in 49 patients (30 PD and 19 AP). Conventional brain MRI was evaluated for regions of atrophy and signal intensity changes. Tract-based spatial statistics and ROI analyses of DTI were performed to analyze group differences in mean diffusivity (MD) and fractional anisotropy (FA), and diagnostic thresholds were determined. Diagnostic accuracy of conventional brain MRI and DTI was assessed with the receiver operating characteristic (ROC). Results Significantly higher MD of the centrum semiovale, body corpus callosum, putamen, external capsule, midbrain, superior cerebellum, and superior cerebellar peduncles was found in AP. Significantly increased MD of the putamen was found in multiple system atrophy–parkinsonian form (MSA-P) and increased MD in the midbrain and superior cerebellar peduncles in progressive supranuclear palsy (PSP). The diagnostic accuracy of brain MRI to identify AP as a group was not improved by ROI measures of MD, though the diagnostic accuracy to identify MSA-P was slightly increased (AUC 0.82 to 0.85). Conclusion The diagnostic accuracy of brain MRI to identify AP as a group was not improved by the current analysis approach to DTI, though DTI measures could be of added value to identify AP subgroups.
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Piattella MC, Tona F, Bologna M, Sbardella E, Formica A, Petsas N, Filippini N, Berardelli A, Pantano P. Disrupted resting-state functional connectivity in progressive supranuclear palsy. AJNR Am J Neuroradiol 2015; 36:915-21. [PMID: 25655870 DOI: 10.3174/ajnr.a4229] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 11/11/2014] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND PURPOSE Studies on functional connectivity in progressive supranuclear palsy have been restricted to the thalamus and midbrain tegmentum. The present study aims to evaluate functional connectivity abnormalities of the subcortical structures in these patients. Functional connectivity will be correlated with motor and nonmotor symptoms of the disease. MATERIALS AND METHODS Nineteen patients with progressive supranuclear palsy (mean age, 70.93 ± 5.19 years) and 12 age-matched healthy subjects (mean age, 69.17 ± 5.20 years) underwent multimodal MR imaging, including fMRI at rest, 3D T1-weighted imaging, and DTI. fMRI data were processed with fMRI of the Brain Software Library tools by using the dorsal midbrain tegmentum, thalamus, caudate nucleus, putamen, and pallidum as seed regions. RESULTS Patients had lower functional connectivity than healthy subjects in all 5 resting-state networks, mainly involving the basal ganglia, thalamus, anterior cingulate, dorsolateral prefrontal and temporo-occipital cortices, supramarginal gyrus, supplementary motor area, and cerebellum. Compared with healthy subjects, patients also displayed subcortical atrophy and DTI abnormalities. Decreased thalamic functional connectivity correlated with clinical scores, as assessed by the Hoehn and Yahr Scale and by the bulbar and mentation subitems of the Progressive Supranuclear Palsy Rating Scale. Decreased pallidum functional connectivity correlated with lower Mini-Mental State Examination scores; decreased functional connectivity in the dorsal midbrain tegmentum network correlated with lower scores in the Frontal Assessment Battery. CONCLUSIONS The present study demonstrates a widespread disruption of cortical-subcortical connectivity in progressive supranuclear palsy and provides further insight into the pathophysiologic mechanisms of motor and cognitive impairment in this condition.
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Affiliation(s)
- M C Piattella
- From the Department of Neurology and Psychiatry (M.C.P., F.T., E.S., A.F., N.P., A.B., P.P.), Sapienza, University of Rome, Italy
| | - F Tona
- From the Department of Neurology and Psychiatry (M.C.P., F.T., E.S., A.F., N.P., A.B., P.P.), Sapienza, University of Rome, Italy
| | - M Bologna
- Neuromed Institute Istituto Di Ricovero e Cura a Carattere Scientifico (M.B., A.B., P.P.), Pozzilli, Italy
| | - E Sbardella
- From the Department of Neurology and Psychiatry (M.C.P., F.T., E.S., A.F., N.P., A.B., P.P.), Sapienza, University of Rome, Italy
| | - A Formica
- From the Department of Neurology and Psychiatry (M.C.P., F.T., E.S., A.F., N.P., A.B., P.P.), Sapienza, University of Rome, Italy
| | - N Petsas
- From the Department of Neurology and Psychiatry (M.C.P., F.T., E.S., A.F., N.P., A.B., P.P.), Sapienza, University of Rome, Italy
| | - N Filippini
- Department of Psychiatry and FMRIB Centre (N.F.), University of Oxford, United Kingdom
| | - A Berardelli
- From the Department of Neurology and Psychiatry (M.C.P., F.T., E.S., A.F., N.P., A.B., P.P.), Sapienza, University of Rome, Italy Neuromed Institute Istituto Di Ricovero e Cura a Carattere Scientifico (M.B., A.B., P.P.), Pozzilli, Italy
| | - P Pantano
- From the Department of Neurology and Psychiatry (M.C.P., F.T., E.S., A.F., N.P., A.B., P.P.), Sapienza, University of Rome, Italy Neuromed Institute Istituto Di Ricovero e Cura a Carattere Scientifico (M.B., A.B., P.P.), Pozzilli, Italy
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Tessitore A, Giordano A, Caiazzo G, Corbo D, De Micco R, Russo A, Liguori S, Cirillo M, Esposito F, Tedeschi G. Clinical correlations of microstructural changes in progressive supranuclear palsy. Neurobiol Aging 2014; 35:2404-10. [PMID: 24786632 DOI: 10.1016/j.neurobiolaging.2014.03.028] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 03/11/2014] [Accepted: 03/23/2014] [Indexed: 11/16/2022]
Abstract
In patients with progressive supranuclear palsy (PSP), previous reports have shown a severe white matter (WM) damage involving supra and infratentorial regions including cerebellum. In the present study, we investigated potential correlations between WM integrity loss and clinical-cognitive features of patients with PSP. By using magnetic resonance imaging and diffusion tensor imaging with tract based spatial statistic analysis, we analyzed WM volume in 18 patients with PSP and 18 healthy controls (HCs). All patients and HCs underwent a detailed clinical and neuropsychological evaluation. Relative to HCs, patients with PSP showed WM changes encompassing supra and infratentorial areas such as corpus callosum, fornix, midbrain, inferior fronto-occipital fasciculus, anterior thalamic radiation, superior cerebellar peduncle, superior longitudinal fasciculus, uncinate fasciculus, cingulate gyrus, and cortico-spinal tract bilaterally. Among different correlations between motor-cognitive features and WM structural abnormalities, we detected a significant association between fronto-cerebellar WM loss and executive cognitive impairment in patients with PSP. Our findings, therefore, corroborate the hypothesis that cognitive impairment in PSP may result from both "intrinsic" and "extrinsic" frontal lobe dysfunction, likely related to cerebellar disconnection.
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Affiliation(s)
| | - Alfonso Giordano
- Department of Neurology, Second University of Naples, Naples, Italy; IDC Hermitage Capodimonte, Naples, Italy
| | - Giuseppina Caiazzo
- MRI Research Center SUN-FISM, Second University of Naples, Naples, Italy
| | - Daniele Corbo
- MRI Research Center SUN-FISM, Second University of Naples, Naples, Italy
| | - Rosa De Micco
- Department of Neurology, Second University of Naples, Naples, Italy
| | - Antonio Russo
- Department of Neurology, Second University of Naples, Naples, Italy; IDC Hermitage Capodimonte, Naples, Italy
| | - Sara Liguori
- Department of Neurology, Second University of Naples, Naples, Italy
| | - Mario Cirillo
- Neuroradiology Service, Second University of Naples, Naples, Italy
| | - Fabrizio Esposito
- Department of Medicine and Surgery, University of Salerno, Baronissi, Italy; Department of Cognitive Neuroscience, Maastricht University, Maastricht, the Netherlands
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Tir M, Delmaire C, Besson P, Defebvre L. The value of novel MRI techniques in Parkinson-plus syndromes: diffusion tensor imaging and anatomical connectivity studies. Rev Neurol (Paris) 2014; 170:266-76. [PMID: 24656811 DOI: 10.1016/j.neurol.2013.10.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 10/14/2013] [Accepted: 10/18/2013] [Indexed: 12/13/2022]
Abstract
Conventional MRI is a well-described, highly useful tool for the differential diagnosis of degenerative parkinsonian syndromes. Nevertheless, the observed abnormalities may only appear in late-stage disease. Diffusion tensor imaging (DTI) can identify microstructural changes in brain tissue integrity and connectivity. The technique has proven value in the differential diagnosis of multiple system atrophy (MSA), progressive supranuclear palsy (PSP) and Parkinson's disease (PD). Here, we performed a systematic review of the literature on the main corticosubcortical DTI abnormalities identified to date in the context of the diagnosis of MSA and PSP with diffusion-weighted imaging, diffusion tensor imaging and anatomical connectivity studies. In good agreement with the histological data, increased diffusivity in the putamen (in MSA and PSP), in the middle cerebellar peduncles (in MSA) and in the upper cerebellar peduncles (in PSP) has been reported. Motor pathway involvement is characterized by low fraction anisotropy (FA) in the primary motor cortex in MSA-P and PSP, a high apparent diffusion coefficient (ADC) and low FA in the supplementary motor area in PSP. We then outline the value of these techniques in differential diagnosis (especially with respect to PD). Anatomical connectivity studies have revealed a lower number of fibers in the corticospinal tract in MSA and PSP (relative to PD and controls) and fewer tracked cortical projection fibers in patients with PSP or late-stage MSA (relative to patients with early MSA or PD and controls). Lastly, we report the main literature data concerning the value of DTI parameters in monitoring disease progression. The observed correlations between DTI parameters on one hand and clinical scores and/or disease duration on the other constitute strong evidence of the value of DTI in monitoring disease progression. In MSA, the ataxia score was correlated with ADC values in the pons and the upper cerebellar peduncles, whereas both the motor score and the disease duration were correlated with putaminal ADC values. In conclusion, DTI and connectivity studies constitute promising tools for differentiating between "Parkinson-plus" syndromes.
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Affiliation(s)
- M Tir
- Service de neurologie et pathologie du mouvement, hôpital Salengro, CHRU de Lille, EA 1046, département de pharmacologie médicale, université Lille Nord de France, 1, place de Verdun, 59045 Lille cedex, France; Service de neurologie, CHU d'Amiens, EA 4559, SFR CAP-Santé (FED 4231), université de Picardie-Jules-Verne, chemin du Thil, 80000 Amiens, France.
| | - C Delmaire
- Service de neuroradiologie, hôpital Salengro, CHRU de Lille, EA 4559, université Lille Nord de France, rue Prof.-Émile-Laine, 59037 Lille cedex, France
| | - P Besson
- Service de neuroradiologie, hôpital Salengro, CHRU de Lille, EA 4559, université Lille Nord de France, rue Prof.-Émile-Laine, 59037 Lille cedex, France
| | - L Defebvre
- Service de neurologie et pathologie du mouvement, hôpital Salengro, CHRU de Lille, EA 1046, département de pharmacologie médicale, université Lille Nord de France, 1, place de Verdun, 59045 Lille cedex, France
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Clinical, cognitive, and behavioural correlates of white matter damage in progressive supranuclear palsy. J Neurol 2014; 261:913-24. [PMID: 24599641 DOI: 10.1007/s00415-014-7301-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 02/21/2014] [Accepted: 02/22/2014] [Indexed: 10/25/2022]
Abstract
White matter (WM) tract alterations were assessed in patients with progressive supranuclear palsy (PSP) relative to healthy controls and patients with idiopathic Parkinson's disease (PD) to explore the relationship of WM tract damage with clinical disease severity, performance on cognitive tests, and apathy. 37 PSP patients, 41 PD patients, and 34 healthy controls underwent an MRI scan and clinical testing to evaluate physical disability, cognitive impairment, and apathy. In PSP, the contribution of WM tract damage to global disease severity and cognitive and behavioural disturbances was assessed using Random Forest analysis. Relative to controls, PSP patients showed diffusion tensor (DT) MRI abnormalities of the corpus callosum, superior cerebellar peduncle (SCP), cingulum and uncinate fasciculus bilaterally, and right inferior longitudinal fasciculus. Corpus callosum and SCP DT MRI measures distinguished PSP from PD patients with high accuracy (area under the curve ranging from 0.89 to 0.72). In PSP, DT MRI metrics of the corpus callosum and superior cerebellar peduncles were the best predictors of global disease severity scale scores. DT MRI metrics of the corpus callosum, right superior longitudinal and inferior longitudinal fasciculus, and left uncinate were the best predictors of executive dysfunction. In PSP, apathy severity was related to the damage to the corpus callosum, right superior longitudinal, and uncinate fasciculi. In conclusion, WM tract damage contributes to the motor, cognitive, and behavioural deficits in PSP. DT MRI offers markers for PSP diagnosis, assessment, and monitoring.
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Ng SH, Hsu WC, Wai YY, Lee JD, Chan HL, Chen YL, Fung HC, Wu YR, Tsai ML, Wang JJ. Sex dimorphism of cortical water diffusion in normal aging measured by magnetic resonance imaging. Front Aging Neurosci 2013; 5:71. [PMID: 24324433 PMCID: PMC3840722 DOI: 10.3389/fnagi.2013.00071] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Accepted: 10/19/2013] [Indexed: 02/01/2023] Open
Abstract
Background: The purpose of this study was to examine sex dimorphism in water diffusion in the brain throughout the normal aging process by magnetic resonance imaging. Methods: Diffusion-weighted images covering the majority of the brain were acquired from 77 healthy participants. Both the mean water diffusivity and diffusion kurtosis were calculated from the cortical regions and parcellated according to the template in anatomical automatic labeling. The mean water diffusivity and diffusion kurtosis from both sexes were examined and subsequently correlated with age. Statistical significance was set at a threshold of p < 0.01 after correction for multiple comparisons. In regions that reached statistical significance, a linear regression model was performed. Analysis of variance was conducted to determine the interaction between aging and sex. Results: Sex differences were observed for three aspects. First, compared to females, males presented increased mean water diffusivity and a decreased diffusion kurtosis in the frontal and temporal lobes. Second, a widespread age-related increase in mean water diffusivity was observed, which was more significant in the frontal, occipital, and temporal areas and in the cingulum in females. Third, the diffusion kurtosis decreased with aging but only in restricted areas for both sexes. For the interaction of aging and sex, the most significant change was observed with regards to mean diffusivity, mostly in the right amygdala. Conclusions: A sex-related dimorphism in water diffusion throughout the aging process was observed in the cortex using magnetic resonance imaging.
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Affiliation(s)
- Shu-Hang Ng
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital Linkou, Taiwan, Republic of China ; Department of Medical Imaging and Radiological Sciences, Chang Gung University Taoyuan County, Taiwan, Republic of China
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Yang J, Shao N, Li J, Shang H. Voxelwise meta-analysis of white matter abnormalities in progressive supranuclear palsy. Neurol Sci 2013; 35:7-14. [DOI: 10.1007/s10072-013-1512-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2013] [Accepted: 07/24/2013] [Indexed: 11/24/2022]
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Meijer FJA, Bloem BR, Mahlknecht P, Seppi K, Goraj B. Update on diffusion MRI in Parkinson's disease and atypical parkinsonism. J Neurol Sci 2013; 332:21-9. [PMID: 23866820 DOI: 10.1016/j.jns.2013.06.032] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 06/24/2013] [Accepted: 06/27/2013] [Indexed: 11/25/2022]
Abstract
Differentiating Parkinson's disease (PD) from other types of neurodegenerative atypical parkinsonism (AP) can be challenging, especially in early disease stages. Routine brain magnetic resonance imaging (MRI) can show atrophy or signal changes in several parts of the brain with fairly high specificity for particular forms of AP, but the overall diagnostic value of routine brain MRI is limited. In recent years, various advanced MRI sequences have become available, including diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI). Here, we review available literature on the value of diffusion MRI for identifying and quantifying different patterns of neurodegeneration in PD and AP, in relation to what is known of underlying histopathologic changes and clinical presentation of these diseases. Next, we evaluate the value of diffusion MRI to differentiate between PD and AP and the potential value of serial diffusion MRI to monitor disease progression. We conclude that diffusion MRI may quantify patterns of neurodegeneration which could be of additional value in clinical use. Future prospective clinical cohort studies are warranted to assess the added diagnostic value of diffusion MRI.
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Affiliation(s)
- Frederick J A Meijer
- Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen, The Netherlands.
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Assessment of global and regional diffusion changes along white matter tracts in parkinsonian disorders by MR tractography. PLoS One 2013; 8:e66022. [PMID: 23785466 PMCID: PMC3681971 DOI: 10.1371/journal.pone.0066022] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Accepted: 04/30/2013] [Indexed: 11/19/2022] Open
Abstract
Purpose The aim of the study was to determine the usefulness of diffusion tensor tractography (DTT) in parkinsonian disorders using a recently developed method for normalization of diffusion data and tract size along white matter tracts. Furthermore, the use of DTT in selected white matter tracts for differential diagnosis was assessed. Methods We quantified global and regional diffusion parameters in major white matter tracts in patients with multiple system atrophy (MSA), progressive nuclear palsy (PSP), idiopathic Parkinson’s disease (IPD) and healthy controls). Diffusion tensor imaging data sets with whole brain coverage were acquired at 3 T using 48 diffusion encoding directions and a voxel size of 2×2×2 mm3. DTT of the corpus callosum (CC), cingulum (CG), corticospinal tract (CST) and middle cerebellar peduncles (MCP) was performed using multiple regions of interest. Regional evaluation comprised projection of fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD) and the apparent area coefficient (AAC) onto a calculated mean tract and extraction of their values along each structure. Results There were significant changes of global DTT parameters in the CST (MSA and PSP), CC (PSP) and CG (PSP). Consistent tract-specific variations in DTT parameters could be seen along each tract in the different patient groups and controls. Regional analysis demonstrated significant changes in the anterior CC (MD, RD and FA), CST (MD) and CG (AAC) of patients with PSP compared to controls. Increased MD in CC and CST, as well as decreased AAC in CG, was correlated with a diagnosis of PSP compared to IPD. Conclusions DTT can be used for demonstrating disease-specific regional white matter changes in parkinsonian disorders. The anterior portion of the CC was identified as a promising region for detection of neurodegenerative changes in patients with PSP, as well as for differential diagnosis between PSP and IPD.
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Rulseh AM, Keller J, Tintěra J, Kožíšek M, Vymazal J. Chasing shadows: What determines DTI metrics in gray matter regions? An in vitro and in vivo study. J Magn Reson Imaging 2013; 38:1103-10. [DOI: 10.1002/jmri.24065] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 01/10/2013] [Indexed: 11/10/2022] Open
Affiliation(s)
- Aaron M. Rulseh
- Department of Radiology; Na Homolce Hospital; Prague Czech Republic
| | - Jiří Keller
- Department of Radiology; Na Homolce Hospital; Prague Czech Republic
- Department of Neurology; Charles University in Prague; 3rd Faculty of Medicine; Prague Czech Republic
| | - Jaroslav Tintěra
- Department of Radiology; Institute for Clinical and Experimental Medicine; Prague Czech Republic
| | - Milan Kožíšek
- Institute of Organic Chemistry and Biochemistry; Academy of Sciences of the Czech Republic; Gilead Sciences and IOCB Research Center; Prague Czech Republic
| | - Josef Vymazal
- Department of Radiology; Na Homolce Hospital; Prague Czech Republic
- Department of Neurology and Center of Clinical Neuroscience; Charles University in Prague; 1st Faculty of Medicine; Prague Czech Republic
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Saini J, Bagepally BS, Sandhya M, Pasha SA, Yadav R, Thennarasu K, Pal PK. Subcortical structures in progressive supranuclear palsy: vertex‐based analysis. Eur J Neurol 2012; 20:493-501. [DOI: 10.1111/j.1468-1331.2012.03884.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Accepted: 08/21/2012] [Indexed: 10/27/2022]
Affiliation(s)
- J. Saini
- Department of Neuroimaging and Interventional Radiology National Institute of Mental Health & Neurosciences Bangalore KarnatakaIndia
| | - B. S. Bagepally
- Department of Neuroimaging and Interventional Radiology National Institute of Mental Health & Neurosciences Bangalore KarnatakaIndia
| | - M. Sandhya
- Department of Neuroimaging and Interventional Radiology National Institute of Mental Health & Neurosciences Bangalore KarnatakaIndia
| | - S. A. Pasha
- Department of Neurology National Institute of Mental Health & Neurosciences Bangalore KarnatakaIndia
| | - R. Yadav
- Department of Neurology National Institute of Mental Health & Neurosciences Bangalore KarnatakaIndia
| | - K. Thennarasu
- Department of Biostatistics National Institute of Mental Health & Neurosciences Bangalore Karnataka India
| | - P. K. Pal
- Department of Neurology National Institute of Mental Health & Neurosciences Bangalore KarnatakaIndia
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Interhemispheric inhibition in different phenotypes of progressive supranuclear palsy. J Neural Transm (Vienna) 2012; 120:453-61. [DOI: 10.1007/s00702-012-0879-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 07/25/2012] [Indexed: 10/28/2022]
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Agosta F, Pievani M, Svetel M, Ječmenica Lukić M, Copetti M, Tomić A, Scarale A, Longoni G, Comi G, Kostić VS, Filippi M. Diffusion tensor MRI contributes to differentiate Richardson's syndrome from PSP-parkinsonism. Neurobiol Aging 2012; 33:2817-26. [PMID: 22418735 DOI: 10.1016/j.neurobiolaging.2012.02.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Accepted: 02/04/2012] [Indexed: 10/28/2022]
Abstract
This study investigated the regional distribution of white matter (WM) damage in Richardson's syndrome (PSP-RS) and progressive supranuclear palsy-Parkinsonism (PSP-P) using diffusion tensor (DT) magnetic resonance imaging (MRI). The DT MRI classificatory ability in diagnosing progressive supranuclear palsy (PSP) syndromes, when used in combination with infratentorial volumetry, was also quantified. In 37 PSP (21 PSP-RS, 16 PSP-P) and 42 controls, the program Tract-Based Spatial Statistics (TBSS; www.fmrib.ox.ac.uk/fsl/tbss) was applied. DT MRI metrics were derived from supratentorial, thalamic, and infratentorial tracts. The magnetic resonance parkinsonism index (MRPI) was calculated. All PSP harbored diffusivity abnormalities in the corpus callosum, frontoparietal, and frontotemporo-occipital tracts. Infratentorial WM and thalamic radiations were severely affected in PSP-RS and relatively spared in PSP-P. When MRPI and DT MRI measures were combined, the discriminatory power increased for each comparison. Distinct patterns of WM alterations occur in PSP-RS and PSP-P. Adding DT MRI measures to MRPI improves the diagnostic accuracy in differentiating each PSP syndrome from healthy individuals and each other.
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Affiliation(s)
- Federica Agosta
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
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Saini J, Bagepally BS, Sandhya M, Pasha SA, Yadav R, Pal PK. In vivo evaluation of white matter pathology in patients of progressive supranuclear palsy using TBSS. Neuroradiology 2011; 54:771-80. [PMID: 22160214 DOI: 10.1007/s00234-011-0983-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Accepted: 11/14/2011] [Indexed: 10/14/2022]
Abstract
INTRODUCTION The purpose of this research is to study white matter (WM) changes in patients of progressive supranuclear palsy (PSP) using automated analysis of diffusion tensor imaging (DTI) indices. METHODS This was a prospective study comprising of 24 patients of PSP and 26 matched healthy controls. Fractional anisotropy, mean diffusivity (MD), axial diffusivity, and radial diffusivity (RD) changes were studied in the WM of the PSP patients using an automated analysis technique, tract-based spatial statistics (TBSS). Two subtypes of PSP, i.e., classic Richardson's syndrome (PSP-RS) and parkinsonian type (PSP-P), were also compared among themselves to identify relative severity of WM changes as well as identify spatial distribution of the differences. Clinicoradiological correlation was done to determine the strength of correlation between WM abnormalities identified using TBSS and clinical scores. RESULTS There were areas of significant abnormality seen in the frontoparietal cerebral WM, thalamus, midbrain tectum, superior cerebellar peduncle, and cerebellar WM. The abnormalities were more spatially widespread on MD and RD maps. Compared to PSP-P, the patients of PSP-RS had more spatial abnormalities localized to the frontal WM. There was no correlation between the observed WM changes and clinical rating scales. CONCLUSIONS The TBSS analysis showed widespread WM abnormalities in PSP patients including areas which have been shown to be involved in previous pathological studies. PSP-RS showed more severe white matter abnormality compared to the PSP-P subtype.
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Affiliation(s)
- Jitender Saini
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore, 560029 Karnataka, India
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Wang JJ, Lin WY, Lu CS, Weng YH, Ng SH, Wang CH, Liu HL, Hsieh RH, Wan YL, Wai YY. Parkinson disease: diagnostic utility of diffusion kurtosis imaging. Radiology 2011; 261:210-7. [PMID: 21771952 DOI: 10.1148/radiol.11102277] [Citation(s) in RCA: 177] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE To examine the usefulness of diffusion kurtosis imaging for the diagnosis of Parkinson disease (PD). MATERIALS AND METHODS Examinations were performed with the understanding and written consent of each subject, with local ethics committee approval, and in compliance with national legislation and Declaration of Helsinki guidelines. Diffusion-weighted magnetic resonance imaging was performed in 30 patients with idiopathic PD (mean age, 64.5 years ± 3.4 [standard deviation]) and 30 healthy subjects (mean age, 65.0 years ± 5.1). Mean kurtosis, fractional anisotropy, and mean, axial, and radial diffusivity of the basal ganglia were compared between the groups. Disease severity was assessed by using Hoehn and Yahr staging and the motor section of the Unified Parkinson's Disease Rating Scale (mean scores, 2.0 and 33.6, respectively). Receiver operating characteristic (ROC) analysis was used to compare the diagnostic accuracies of the indexes of interest. Pearson correlation coefficient analysis was used to correlate imaging findings with disease severity. RESULTS Mean kurtosis in the putamen was higher in the PD group (0.93 ± 0.15) than in the control group (0.71 ± 0.09) (P < .000416). The area under the ROC curve (AUC) was 0.95 for both the ipsilateral putamen and the ipsilateral substantia nigra. The mean kurtosis for the ipsilateral substantia nigra had the best diagnostic performance (mean cutoff, 1.10; sensitivity, 0.92; specificity, 0.87). In contrast, AUCs for the tensor-derived indexes ranged between 0.43 (axial and radial diffusivity in substantia nigra) and 0.65 (fractional anisotropy in substantia nigra). CONCLUSION Diffusion kurtosis imaging in the basal ganglia, as compared with conventional diffusion-tensor imaging, can improve the diagnosis of PD.
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Affiliation(s)
- Jiun-Jie Wang
- Department of Medical Imaging and Intervention and Neurology, and Neuroscience Research Center, Chang-Gung Memorial Hospital LinKou Medical Center, Taiwan, Republic of China
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Canu E, Agosta F, Baglio F, Galantucci S, Nemni R, Filippi M. Diffusion tensor magnetic resonance imaging tractography in progressive supranuclear palsy. Mov Disord 2011; 26:1752-5. [PMID: 21500281 DOI: 10.1002/mds.23739] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Revised: 02/16/2011] [Accepted: 03/10/2011] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Diffusion tensor magnetic resonance imaging tractography allows quantification of in vivo white matter tract damage. METHODS Using tractography, diffusion tensor magnetic resonance imaging metrics were obtained from the superior and middle cerebellar peduncles and major cerebral white matter tracts in 5 patients with progressive supranuclear palsy and 13 controls. RESULTS Patients showed severe intrinsic damage to the superior cerebellar peduncle, corpus callosum, and cingulum bilaterally. Only decreased axial diffusivity was found in the left middle cerebellar peduncle. CONCLUSIONS Diffusion tensor magnetic resonance imaging tractography holds promise for providing accurate in vivo cartography of progressive supranuclear palsy tissue damage.
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Affiliation(s)
- Elisa Canu
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, Scientific Institute and University Hospital San Raffaele, Milan, Italy
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Yuan W, Deren KE, McAllister JP, Holland SK, Lindquist DM, Cancelliere A, Mason M, Shereen A, Hertzler DA, Altaye M, Mangano FT. Diffusion tensor imaging correlates with cytopathology in a rat model of neonatal hydrocephalus. Cerebrospinal Fluid Res 2010; 7:19. [PMID: 21054844 PMCID: PMC2989304 DOI: 10.1186/1743-8454-7-19] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2010] [Accepted: 11/05/2010] [Indexed: 11/23/2022] Open
Abstract
Background Diffusion tensor imaging (DTI) is a non-invasive MRI technique that has been used to quantify CNS abnormalities in various pathologic conditions. This study was designed to quantify the anisotropic diffusion properties in the brain of neonatal rats with hydrocephalus (HCP) and to investigate association between DTI measurements and cytopathology. Methods DTI data were acquired between postnatal day 7 (P7) and P12 in 12 rats with HCP induced at P2 and in 15 age-matched controls. Animals were euthanized at P11 or P22/P23 and brains were processed with immunohistochemistry for glial fibrillary acidic protein (GFAP), ionized calcium-binding adaptor molecule (Iba-1), and luxol fast blue (LFB) to assess astrocytosis, microglial reactivity and degree of myelination, respectively. Results Hydrocephalic rats were consistently found to have an abnormally low (at corrected p-level of <0.05) fractional anisotropy (FA) value and an abnormally high mean diffusivity (MD) value in the cerebral cortex (CX), the corpus callosum (CC), and the internal capsule (IC). Immunohistochemical analysis demonstrated trends of increasing astrocyte and microglial reactivity in HCP rats at P11 that reached statistical significance at P22/P23. A trend toward reduced myelination in the HCP rats was also found at P22/P23. Correlation analysis at P11 for the CC demonstrated statistically significant correlations (or trends) between the DTI measurement (the decreased FA and increased MD values) and the GFAP or Iba-1 rankings. The immunohistochemical rankings in the IC at P22/P23 were also significantly correlated or demonstrated a trend with both FA and MD values. Conclusions This study demonstrates the feasibility of employing DTI on the brain in experimental hydrocephalus in neonatal rats and reveals impairments in multiple regions of interest in both grey and white matter. A strong correlation was found between the immunohistochemical results and the changes in anisotropic diffusion properties.
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Affiliation(s)
- Weihong Yuan
- Division of Pediatric Neurosurgery, University of Cincinnati, Cincinnati Children's Hospital Medical Center MLC 2016, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
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