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Lee DH, Heo H, Suh CH, Shim WH, Kim E, Jo S, Chung SJ, Lee CS, Kim HS, Kim SJ. Improved diagnostic performance of susceptibility-weighted imaging with compressed sensing-sensitivity encoding and neuromelanin-sensitive MRI for Parkinson's disease and atypical Parkinsonism. Clin Radiol 2024; 79:e102-e111. [PMID: 37863747 DOI: 10.1016/j.crad.2023.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 08/08/2023] [Accepted: 09/18/2023] [Indexed: 10/22/2023]
Abstract
AIM To verify the diagnostic performance of the loss of nigrosome-1 on susceptibility-weighted imaging (SWI) with compressed sensing-sensitivity encoding (CS-SENSE) and neuromelanin on neuromelanin-sensitive (NM) magnetic resonance imaging (MRI) for the diagnosis of Parkinson's disease (PD) and atypical Parkinsonism. MATERIALS AND METHODS A total of 195 patients who underwent MRI between October 2019 and February 2020, including SWI, with or without CS-SENSE, and NM-MRI, were reviewed retrospectively. Two neuroradiologists assessed the loss of nigrosome-1 on SWI and neuromelanin on the NM-MRI. The result of N-3-fluoropropyl-2-beta-carbomethoxy-3-beta-(4-iodophenyl) nortropane positron-emission tomography (PET) was set as the reference standard. RESULTS When CS-SENSE was applied for nigrosome-1 imaging on SWI, the non-diagnostic scan rate was lowered significantly from 19.3% (17/88) to 5.6% (6/107; p=0.004). Diagnosis of PD and atypical Parkinsonism based on the loss of nigrosome-1 on SWI and based on NM-MRI showed good diagnostic value (area under the curve [AUC] 0.821, 95% confidence interval [CI] = 0.755-0.875: AUC 0.832, 95% CI = 0.771-0.882, respectively) with a substantial inter-reader agreement (κ = 0.791 and 0.681, respectively). Combined SWI and neuromelanin had a similar discriminatory ability (AUC 0.830, 95% CI = 0.770-0.880). Similarly, the diagnosis of PD was excellent. CONCLUSIONS CS-SENSE may add value to the diagnostic capability of nigrosome-1 on SWI to reduce the nondiagnostic scan rates. Furthermore, loss of nigrosome-1 on SWI or volume loss of neuromelanin on NM-MRI may be helpful for diagnosing PD.
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Affiliation(s)
- D H Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea; Department of Radiology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - H Heo
- Department of Convergence Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - C H Suh
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
| | - W H Shim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - E Kim
- Philips Healthcare Korea, Seoul, Republic of Korea
| | - S Jo
- Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - S J Chung
- Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - C S Lee
- Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - H S Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - S J Kim
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
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Chen ZT, Pan CZ, Ruan XL, Lei LP, Lin SM, Wang YZ, Zhao ZH. Evaluation of ferritin and TfR level in plasma neural-derived exosomes as potential markers of Parkinson's disease. Front Aging Neurosci 2023; 15:1216905. [PMID: 37794977 PMCID: PMC10546046 DOI: 10.3389/fnagi.2023.1216905] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 09/04/2023] [Indexed: 10/06/2023] Open
Abstract
Introduction Early diagnosis of Parkinson's disease (PD) remains challenging. It has been suggested that abnormal brain iron metabolism leads to excessive iron accumulation in PD, although the mechanism of iron deposition is not yet fully understood. Ferritin and transferrin receptor (TfR) are involved in iron metabolism, and the exosome pathway is one mechanism by which ferritin is transported and regulated. While the blood of healthy animals contains a plentiful supply of TfR-positive exosomes, no studies have examined ferritin and TfR in plasma neural-derived exosomes. Methods Plasma exosomes were obtained from 43 patients with PD and 34 healthy controls. Neural-derived exosomes were isolated with anti-human L1CAM antibody immunoabsorption. Transmission electron microscopy and western blotting were used to identify the exosomes. ELISAs were used to quantify ferritin and TfR levels in plasma neural-derived exosomes of patients with PD and controls. Receivers operating characteristic (ROC) curves were applied to map the diagnostic accuracy of ferritin and TfR. Independent predictors of the disease were identified using logistic regression models. Results Neural-derived exosomes exhibited the typical exosomal morphology and expressed the specific exosome marker CD63. Ferritin and TfR levels in plasma neural-derived exosomes were significantly higher in patients with PD than controls (406.46 ± 241.86 vs. 245.62 ± 165.47 ng/μg, P = 0.001 and 1728.94 ± 766.71 vs. 1153.92 ± 539.30 ng/μg, P < 0.001, respectively). There were significant positive correlations between ferritin and TfR levels in plasma neural-derived exosomes in control group, PD group and all the individuals (rs = 0.744, 0.700, and 0.752, respectively). The level of TfR was independently associated with the disease (adjusted odds ratio 1.002; 95% CI 1.000-1.003). ROC performances of ferritin, TfR, and their combination were moderate (0.730, 0.812, and 0.808, respectively). However, no relationship was found between the biomarkers and disease progression. Conclusion It is hypothesized that ferritin and TfR in plasma neural-derived exosomes may be potential biomarkers for PD, and that they may participate in the mechanism of excessive iron deposition in PD.
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Affiliation(s)
- Zhi-ting Chen
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Chu-zhui Pan
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China
- Department of Neurology, Fujian Provincial Hospital, Fuzhou, Fujian, China
| | - Xing-lin Ruan
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China
| | - Li-ping Lei
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China
- Department of Neurology, Fujian Provincial Hospital, Fuzhou, Fujian, China
| | - Sheng-mei Lin
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China
- Department of Neurology, Fujian Provincial Hospital, Fuzhou, Fujian, China
| | - Yin-zhou Wang
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China
- Department of Neurology, Fujian Provincial Hospital, Fuzhou, Fujian, China
| | - Zhen-Hua Zhao
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China
- Department of Neurology, Fujian Provincial Hospital, Fuzhou, Fujian, China
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Tinaz S. Magnetic resonance imaging modalities aid in the differential diagnosis of atypical parkinsonian syndromes. Front Neurol 2023; 14:1082060. [PMID: 36816565 PMCID: PMC9932598 DOI: 10.3389/fneur.2023.1082060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 01/16/2023] [Indexed: 02/05/2023] Open
Abstract
Accurate and timely diagnosis of atypical parkinsonian syndromes (APS) remains a challenge. Especially early in the disease course, the clinical manifestations of the APS overlap with each other and with those of idiopathic Parkinson's disease (PD). Recent advances in magnetic resonance imaging (MRI) technology have introduced promising imaging modalities to aid in the diagnosis of APS. Some of these MRI modalities are also included in the updated diagnostic criteria of APS. Importantly, MRI is safe for repeated use and more affordable and accessible compared to nuclear imaging. These advantages make MRI tools more appealing for diagnostic purposes. As the MRI field continues to advance, the diagnostic use of these techniques in APS, alone or in combination, are expected to become commonplace in clinical practice.
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Affiliation(s)
- Sule Tinaz
- Division of Movement Disorders, Department of Neurology, Yale School of Medicine, New Haven, CT, United States
- Department of Neurology, Clinical Neurosciences Imaging Center, Yale School of Medicine, New Haven, CT, United States
- *Correspondence: Sule Tinaz ✉
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Li W, Gao B, Du W, Jiang Y, Yang J, Hu R, Liu Y, Liu N, Zhang Y, Song Q, Miao Y. Iron deposition heterogeneity in extrapyramidal system assessed by quantitative susceptibility mapping in Parkinson’s disease patients with type 2 diabetes mellitus. Front Aging Neurosci 2022; 14:975390. [PMID: 36177478 PMCID: PMC9513156 DOI: 10.3389/fnagi.2022.975390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose Excessive brain iron depositions were found in both patients with Parkinson’s disease (PD) and those with type 2 diabetes mellitus (T2DM). The present study aimed to explore iron deposition and heterogeneity in the extrapyramidal system in PD patients with T2DM using quantitative susceptibility mapping (QSM) and further to reveal the effect of T2DM on the changes in brain iron in patients with PD. Materials and methods A total of 38 PD patients with T2DM (PDDM), 30 PD patients without T2DM (PDND), and 20 asymptomatic control subjects (CSs) were recruited for this study. All subjects underwent multiple MRI sequences involving enhanced gradient echo T2 star weighted angiography (ESWAN). The magnetic sensitivity values (MSV) and volume of the whole nuclei (MSVW, VW) and high iron region (MSVRII, VRII) were measured on the bilateral caudate nucleus (CN), the putamen (PUT), the globus pallidus (GP), the substantia nigra (SN), the red nucleus (RN) and the dentate nucleus (DN). Clinical and laboratory data were recorded, especially for the Hoehn and Yahr (H-Y) stage, the Montreal Cognitive Assessment (MoCA), the Mini-Mental State Examination (MMSE), the Hamilton Depression Rating Scale (HAMD), and the Hamilton Anxiety Rating Scale (HAMA). All QSM data were compared between PDDM and PDND groups and correlated with clinical and laboratory data. Results Compared to the PDND group, the VRII/VW of the left CN was significantly increased in the PDDM group. Significantly higher MSVW and MSVRII were also found in the PDDM group, including bilateral SN of MSVW, right PUT, and bilateral CN, GP, and SN of MSVRII. The H-Y stage of the PDDM group was significantly higher than that of the PDND group. The MSVRII of bilateral RN of the PDDM group was positively correlated with the HAMA scores. HDL, DBP, and SBP levels were associated with MSVRII of right CN in the PDDM group. Conclusion T2DM could aggravate the disease severity and anxiety in patients with PD. The iron distribution of deep gray matter nuclei in PD patients with T2DM was significantly heterogeneous, which was related to blood pressure and blood lipids.
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Nikparast F, Ganji Z, Danesh Doust M, Faraji R, Zare H. Brain pathological changes during neurodegenerative diseases and their identification methods: How does QSM perform in detecting this process? Insights Imaging 2022; 13:74. [PMID: 35416533 PMCID: PMC9008086 DOI: 10.1186/s13244-022-01207-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 03/13/2022] [Indexed: 12/14/2022] Open
Abstract
The presence of iron is essential for many biological processes in the body. But sometimes, for various reasons, the amount of iron deposition in different areas of the brain increases, which leads to problems related to the nervous system. Quantitative susceptibility mapping (QSM) is one of the newest magnetic resonance imaging (MRI)-based methods for assessing iron accumulation in target areas. This Narrative Review article aims to evaluate the performance of QSM compared to other methods of assessing iron deposition in the clinical field. Based on the results, we introduced related basic definitions, some neurodegenerative diseases, methods of examining iron deposition in these diseases, and their advantages and disadvantages. This article states that the QSM method can be introduced as a new, reliable, and non-invasive technique for clinical evaluations.
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Affiliation(s)
- Farzaneh Nikparast
- Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zohreh Ganji
- Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Danesh Doust
- Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reyhane Faraji
- Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hoda Zare
- Medical Physics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. .,Department of Medical Physics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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An Updated Overview of the Magnetic Resonance Imaging of Brain Iron in Movement Disorders. Behav Neurol 2022; 2022:3972173. [PMID: 35251368 PMCID: PMC8894064 DOI: 10.1155/2022/3972173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 01/29/2022] [Indexed: 01/12/2023] Open
Abstract
Brain iron load is one of the most important neuropathological hallmarks in movement disorders. Specifically, the iron provides most of the paramagnetic metal signals in the brain and its accumulation seems to play a key role, although not completely explained, in the degeneration of the basal ganglia, as well as other brain structures. Moreover, iron distribution patterns have been implicated in depicting different movement disorders. This work reviewed current literature on Magnetic Resonance Imaging for Brain Iron Detection and Quantification (MRI-BIDQ) in neurodegenerative processes underlying movement disorders.
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Feraco P, Gagliardo C, La Tona G, Bruno E, D’angelo C, Marrale M, Del Poggio A, Malaguti MC, Geraci L, Baschi R, Petralia B, Midiri M, Monastero R. Imaging of Substantia Nigra in Parkinson's Disease: A Narrative Review. Brain Sci 2021; 11:brainsci11060769. [PMID: 34207681 PMCID: PMC8230134 DOI: 10.3390/brainsci11060769] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/02/2021] [Accepted: 06/05/2021] [Indexed: 12/15/2022] Open
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disorder, characterized by motor and non-motor symptoms due to the degeneration of the pars compacta of the substantia nigra (SNc) with dopaminergic denervation of the striatum. Although the diagnosis of PD is principally based on a clinical assessment, great efforts have been expended over the past two decades to evaluate reliable biomarkers for PD. Among these biomarkers, magnetic resonance imaging (MRI)-based biomarkers may play a key role. Conventional MRI sequences are considered by many in the field to have low sensitivity, while advanced pulse sequences and ultra-high-field MRI techniques have brought many advantages, particularly regarding the study of brainstem and subcortical structures. Nowadays, nigrosome imaging, neuromelanine-sensitive sequences, iron-sensitive sequences, and advanced diffusion weighted imaging techniques afford new insights to the non-invasive study of the SNc. The use of these imaging methods, alone or in combination, may also help to discriminate PD patients from control patients, in addition to discriminating atypical parkinsonian syndromes (PS). A total of 92 articles were identified from an extensive review of the literature on PubMed in order to ascertain the-state-of-the-art of MRI techniques, as applied to the study of SNc in PD patients, as well as their potential future applications as imaging biomarkers of disease. Whilst none of these MRI-imaging biomarkers could be successfully validated for routine clinical practice, in achieving high levels of accuracy and reproducibility in the diagnosis of PD, a multimodal MRI-PD protocol may assist neuroradiologists and clinicians in the early and differential diagnosis of a wide spectrum of neurodegenerative disorders.
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Affiliation(s)
- Paola Feraco
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Via S. Giacomo 14, 40138 Bologna, Italy;
- Neuroradiology Unit, S. Chiara Hospital, 38122 Trento, Italy;
| | - Cesare Gagliardo
- Section of Radiological Sciences, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (G.L.T.); (E.B.); (C.D.); (M.M.)
- Correspondence:
| | - Giuseppe La Tona
- Section of Radiological Sciences, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (G.L.T.); (E.B.); (C.D.); (M.M.)
| | - Eleonora Bruno
- Section of Radiological Sciences, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (G.L.T.); (E.B.); (C.D.); (M.M.)
| | - Costanza D’angelo
- Section of Radiological Sciences, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (G.L.T.); (E.B.); (C.D.); (M.M.)
| | - Maurizio Marrale
- Department of Physics and Chemistry, University of Palermo, 90128 Palermo, Italy;
| | - Anna Del Poggio
- Department of Neuroradiology and CERMAC, San Raffaele Scientific Institute, San Raffaele Vita-Salute University, 20132 Milan, Italy;
| | | | - Laura Geraci
- Diagnostic and Interventional Neuroradiology Unit, A.R.N.A.S. Civico-Di Cristina-Benfratelli, 90127 Palermo, Italy;
| | - Roberta Baschi
- Section of Neurology, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (R.B.); (R.M.)
| | | | - Massimo Midiri
- Section of Radiological Sciences, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (G.L.T.); (E.B.); (C.D.); (M.M.)
| | - Roberto Monastero
- Section of Neurology, Department of Biomedicine, Neurosciences & Advanced Diagnostics, School of Medicine, University of Palermo, 90127 Palermo, Italy; (R.B.); (R.M.)
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Update on neuroimaging for categorization of Parkinson's disease and atypical parkinsonism. Curr Opin Neurol 2021; 34:514-524. [PMID: 34010220 DOI: 10.1097/wco.0000000000000957] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW Differential diagnosis of Parkinsonism may be difficult. The objective of this review is to present the work of the last three years in the field of imaging for diagnostic categorization of parkinsonian syndromes focusing on progressive supranuclear palsy (PSP) and multiple system atrophy (MSA). RECENT FINDINGS Two main complementary approaches are being pursued. The first seeks to develop and validate manual qualitative or semi-quantitative imaging markers that can be easily used in clinical practice. The second is based on quantitative measurements of magnetic resonance imaging abnormalities integrated in a multimodal approach and in automatic categorization machine learning tools. SUMMARY These two complementary approaches obtained high diagnostic around 90% and above in the classical Richardson form of PSP and probable MSA. Future work will determine if these techniques can improve diagnosis in other PSP variants and early forms of the diseases when all clinical criteria are not fully met.
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Cho SJ, Bae YJ, Kim JM, Kim HJ, Baik SH, Sunwoo L, Choi BS, Jung C, Kim JH. Iron-sensitive magnetic resonance imaging in Parkinson's disease: a systematic review and meta-analysis. J Neurol 2021; 268:4721-4736. [PMID: 33914142 DOI: 10.1007/s00415-021-10582-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/23/2021] [Accepted: 04/24/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate the diagnostic performance of iron-sensitive sequences targeting the substantia nigra for distinguishing patients with Parkinson's disease from control participants and to identify factors causing heterogeneity. METHODS A systematic literature search in the Ovid-MEDLINE and EMBASE databases was performed for studies reporting the relevant topic before March 6, 2020. The pooled sensitivity and specificity values with their 95% confidence intervals were calculated using bivariate random-effects modeling. Subgroup and meta-regression analyses were also performed to determine factors influencing heterogeneity affecting the diagnostic performance among the clinical, MRI, and analytic characteristics. RESULTS A total of 22 articles including 1126 patients with Parkinson's disease and 933 control participants were enrolled in this systematic review and meta-analysis. Of those, 12 studies used objective analyses of quantitative susceptibility measurements, and 10 visually assessed the nigrosome-1 in subjective analyses. Iron-sensitive nigral magnetic resonance imaging showed a pooled sensitivity of 92% (95% confidence interval 88-95%) and a pooled specificity of 90% (95% confidence interval 81-95%). According to subgroup and meta-regression analyses, a longer mean disease duration in patients with Parkinson's disease (≥ 5 years), subjective analysis, a smaller size of pixel (< 0.6 mm2), a larger flip angle (> 15°), a smaller slice thickness (≤ 1 mm), and specific targeting of the substantia nigra pars compacta improved the diagnostic performance. CONCLUSION Iron-sensitive nigral magnetic resonance imaging had a favorable diagnostic performance in discriminating patients with Parkinson's disease from control participants. Subjective analytic methods remain superior to objective approaches. Further improvements of the spatial resolution and contrast-to-noise ratio to specifically target the nigrosome-1 with objective analytic methods will be needed.
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Affiliation(s)
- Se Jin Cho
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi, 13620, Republic of Korea
| | - Yun Jung Bae
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi, 13620, Republic of Korea.
| | - Jong-Min Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi, 13620, Republic of Korea
| | - Hyun Jin Kim
- Department of Radiology, Daejin Medical Center, Bundang Jesaeng General Hospital, Seongnam, Gyeonggi, Republic of Korea
| | - Sung Hyun Baik
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi, 13620, Republic of Korea
| | - Leonard Sunwoo
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi, 13620, Republic of Korea
| | - Byung Se Choi
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi, 13620, Republic of Korea
| | - Cheolkyu Jung
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi, 13620, Republic of Korea
| | - Jae Hyoung Kim
- Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173beon-gil, Bundang-gu, Seongnam, Gyeonggi, 13620, Republic of Korea
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Michler E, Kaiser D, Eleftheriadou K, Falkenburger B, Kotzerke J, Hoberück S. Comparison of 6-[ 18F]FDOPA PET with Nigrosome 1 detection in patients with parkinsonism. EJNMMI Res 2021; 11:16. [PMID: 33590381 PMCID: PMC7884547 DOI: 10.1186/s13550-021-00758-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 02/03/2021] [Indexed: 11/20/2022] Open
Abstract
Background The functional 6-[18F]FDOPA positron emission tomography (PET) can be a helpful tool in differentiating parkinsonism with dopaminergic deficiency from clinically similar differential diagnoses. Furthermore, in T2*/susceptibility-weighted imaging (SWI) magnetic resonance imaging (MRI) sequences the structural integrity of the Nigrosome 1 (N1) can be assessed by checking the presence of the swallow tail sign (STS). We therefore retrospectively compared the performance of the 6-[18F]FDOPA PET with the N1 detection in patients suspected with parkinsonian diseases. Forty-three consecutive patients (m: 23, f: 20, mean age: 63 ± 12 years) were included in the study. They underwent clinically indicated 6-[18F]FDOPA PET/MRI scans as part of their neurological evaluation of uncertain parkinsonian syndromes. Visual and semi-quantitative PET imaging results were statistically compared with visual N1 assessment on 3 T SWI. As the gold standard, we defined the clinical diagnosis at the last follow-up, which included idiopathic Parkinson syndrome (IPS; n = 18), atypical parkinsonian syndromes (APS; n = 9) and other neurological diseases without dopaminergic deficit (n = 16). Results Thirty-five of 43 patients (81%, Kappa 0.611) had corresponding results in 6-[18F]FDOPA PET and SWI. Seven of the remaining 8 patients were correctly diagnosed by 6-[18F]FDOPA PET alone. Sensitivity, specificity and accuracy for 6-[18F]FDOPA and N1 imaging were 93%, 94%, 93% and 82%, 75%, 79%, respectively. Conclusions 6-[18F]FDOPA PET and Nigrosome 1 evaluation had an overall good intermodality agreement. Diagnostic agreement was very good in cases of clinically suspected idiopathic Parkinson syndrome and fair in atypical parkinsonian syndromes, but poor in patients with non-parkinsonian disorders. 6-[18F]FDOPA PET showed higher sensitivity, specificity and accuracy in discriminating parkinsonian syndromes from non-parkinsonian disorders than the N1 evaluation. In summary, the additional benefit of N1 assessment in patients with APS or parkinsonism without dopaminergic deficit needs to be proven by prospective studies.
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Affiliation(s)
- Enrico Michler
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany.
| | - Daniel Kaiser
- Department of Neuroradiology, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Kiriaki Eleftheriadou
- Department of Neurology, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Björn Falkenburger
- Department of Neurology, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany.,German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
| | - Jörg Kotzerke
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Sebastian Hoberück
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
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Kimber TE. Approach to the patient with early Parkinson disease: diagnosis and management. Intern Med J 2021; 51:20-26. [DOI: 10.1111/imj.15148] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/09/2020] [Accepted: 11/19/2020] [Indexed: 01/07/2023]
Affiliation(s)
- Thomas E. Kimber
- Neurology Unit Royal Adelaide Hospital Adelaide South Australia Australia
- University Department of Medicine, Faculty of Health and Medical Sciences University of Adelaide Adelaide South Australia Australia
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Liu X, Wang N, Chen C, Wu PY, Piao S, Geng D, Li Y. Swallow tail sign on susceptibility map-weighted imaging (SMWI) for disease diagnosing and severity evaluating in parkinsonism. Acta Radiol 2021; 62:234-242. [PMID: 32380911 DOI: 10.1177/0284185120920793] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Loss of swallow tail sign (STS) on iron-sensitive magnetic resonance imaging (MRI) has been recognized as an imaging feature in parkinsonism (PS). PURPOSE To investigate the diagnostic and differential diagnostic value of STS scale on susceptibility map-weighted imaging (SMWI) in PS, including Parkinson's disease (PD), progressive supranuclear palsy syndrome (PSP), and multiple system atrophy (MSA), and to evaluate its correlation with disease severity. MATERIAL AND METHODS Ninety-nine patients (55 PD, 29 PSP, and 15 MSA) and 47 healthy controls (HC) were prospectively recruited and scanned using quantitative susceptibility mapping (QSM). STS was visually assessed on SMWI derived from QSM. STS scale in the range of 0-4 at participant level was calculated by summing bilateral STS scores (0-2). We used receiver operating characteristic analysis of STS scale for evaluating the diagnostic power of parkinsonism and Spearman's correlation for assessing disease severity. RESULTS Frequency distribution of STS scale was significantly different in parkinsonism and HC groups, and among PD, PSP, and MSA subgroups. STS scale ≤3 could distinguish parkinsonism from HC with high accuracy (91.78%), PD from HC (91.18%), and MSA from HC (88.71%). STS scale ≤2 could distinguish PSP from HC (96.05%). STS scale = 0 could distinguish PSP from PD (70.24%) and PSP from MSA (72.73%). STS scale was negatively correlated with H-Y stage (P = 0.007, r = -0.359) and duration of disease (P = 0.006, r = -0.367) in PD patients. CONCLUSION STS scale on SMWI may serve as a useful imaging biomarker for diagnosis of parkinsonism and disease progression evaluation in PD.
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Affiliation(s)
- Xueling Liu
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, PR China
| | - Na Wang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, PR China
- Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, PR China
| | - Chen Chen
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, PR China
| | - Pu-Yeh Wu
- GE Healthcare China, Beijing, PR China
| | - Sirong Piao
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, PR China
- Institute of Functional and Molecular Medical Imaging, Fudan University, Shanghai, PR China
| | - Daoying Geng
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, PR China
| | - Yuxin Li
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, PR China
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Diagnostic performance of loss of nigral hyperintensity on susceptibility-weighted imaging in parkinsonism: an updated meta-analysis. Eur Radiol 2021; 31:6342-6352. [PMID: 33449183 DOI: 10.1007/s00330-020-07627-6] [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: 08/19/2020] [Revised: 11/21/2020] [Accepted: 12/10/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To evaluate diagnostic performance of loss of nigral hyperintensity on SWI in differentiating idiopathic Parkinson's disease (IPD) or primary parkinsonism (including IPD and Parkinson-plus syndrome) from healthy/disease controls. METHODS MEDLINE/PubMed and EMBASE databases were searched to identify original articles investigating the diagnostic performance of loss of nigral hyperintensity for differentiating IPD or primary parkinsonism from healthy/disease control, up to April 3, 2020. Pooled sensitivity and specificity were calculated using a bivariate random-effects model. The proportion of nondiagnostic scan, inter- and intrareader agreement, and the proportion of concordance between clinical laterality and imaging asymmetry were also pooled. RESULTS Nineteen articles covering 2125 patients (1097 with primary parkinsonism, 1028 healthy/disease controls) were included. For discrimination between IPD and healthy/disease controls, pooled sensitivity and specificity were 0.96 (95% CI, 0.91-0.98) and 0.95 (95% CI, 0.92-0.97). For discrimination between primary parkinsonism and healthy/disease controls, pooled sensitivity and specificity were 0.87 (95% CI, 0.75-0.94) and 0.93 (95% CI, 0.85-0.97). The pooled proportion of non-diagnostic scans on random-effects modeling was 4.2% (95% CI, 2.5-6.9%). The inter- and intrareader agreements were almost perfect, with the pooled coefficients being 0.84 (95% CI, 0.78-0.89) and 0.96 (95% CI, 0.89-0.99), respectively. The pooled proportion of concordant cases was 69.3% (95% CI, 58.4-78.4%). CONCLUSIONS Loss of nigral hyperintensity on SWI can differentiate IPD or primary parkinsonism from a healthy/disease control group with high accuracy. However, the proportion of non-diagnostic scans is not negligible and must be taken into account. KEY POINTS • For discrimination between idiopathic Parkinson's disease and healthy/disease controls, pooled sensitivity and specificity of loss of nigral hyperintensity were 0.96 and 0.95. • For discrimination between primary parkinsonism and healthy/disease controls, pooled sensitivity and specificity of loss of nigral hyperintensity were 0.87 and 0.93. • The pooled proportion of non-diagnostic scans on random-effects modeling was 4.2%.
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Hernadi G, Pinter D, Nagy SA, Orsi G, Komoly S, Janszky J, Kovacs N, Perlaki G. Fast 3 T nigral hyperintensity magnetic resonance imaging in Parkinson's disease. Sci Rep 2021; 11:1179. [PMID: 33441889 PMCID: PMC7806895 DOI: 10.1038/s41598-020-80836-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 12/23/2020] [Indexed: 11/20/2022] Open
Abstract
The absence of nigral hyperintensity is a promising MR marker for Parkinson’s disease (PD), but its small size imposes limitations on its routine use. Our aim was to compare Multi Echo Data Image Combination (MEDIC), segmented echo-planar imaging (EPISEG) and fluid-attenuated inversion recovery (FLAIR) sequences, as well as both magnitude (MAG) and susceptibility-weighted imaging (SWI) reconstructions of single-echo gradient echo for nigral hyperintensity imaging. Twenty-five healthy and twenty PD subjects were included. Sensitivity to motion artefacts, confidence of the radiologist in interpretation, rate of nondiagnostic scans and diagnostic accuracy were assessed. EPISEG was less motion-sensitive than MEDIC, MAG, and SWI, while FLAIR was less motion-sensitive than MAG and SWI. The reviewers were more confident when using EPISEG compared to any other techniques and MEDIC was superior to FLAIR. The proportions of nondiagnostic scans were lower for EPISEG than for other sequences. The best diagnostic performance was achieved for EPISEG (sensitivity = 65%, specificity = 96%). Using EPISEG, the absence of nigral hyperintensity in PD was associated with higher Hoehn-Yahr stage and MDS-UPDRS II + III. Nigral hyperintensity may be intact at the very early stages of PD. The promising properties of EPISEG may help the transfer of nigral hyperintensity imaging into daily clinical practice.
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Affiliation(s)
| | - David Pinter
- Department of Neurology, Medical School, University of Pecs, Pecs, Hungary
| | - Szilvia Anett Nagy
- Pecs Diagnostic Centre, Pecs, Hungary.,MTA-PTE Clinical Neuroscience MR Research Group, Pecs, Hungary.,Neurobiology of Stress Research Group, Szentagothai Research Center, University of Pecs, Pecs, Hungary.,Department of Laboratory Medicine, Medical School, University of Pecs, Pecs, Hungary
| | - Gergely Orsi
- Pecs Diagnostic Centre, Pecs, Hungary.,Department of Neurology, Medical School, University of Pecs, Pecs, Hungary.,MTA-PTE Clinical Neuroscience MR Research Group, Pecs, Hungary
| | - Samuel Komoly
- Department of Neurology, Medical School, University of Pecs, Pecs, Hungary
| | - Jozsef Janszky
- Department of Neurology, Medical School, University of Pecs, Pecs, Hungary.,MTA-PTE Clinical Neuroscience MR Research Group, Pecs, Hungary
| | - Norbert Kovacs
- Department of Neurology, Medical School, University of Pecs, Pecs, Hungary.,MTA-PTE Clinical Neuroscience MR Research Group, Pecs, Hungary
| | - Gabor Perlaki
- Pecs Diagnostic Centre, Pecs, Hungary. .,Department of Neurology, Medical School, University of Pecs, Pecs, Hungary. .,MTA-PTE Clinical Neuroscience MR Research Group, Pecs, Hungary.
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Fedeli MP, Contarino VE, Siggillino S, Samoylova N, Calloni S, Melazzini L, Conte G, Sacilotto G, Pezzoli G, Triulzi FM, Scola E. Iron deposition in Parkinsonisms: A Quantitative Susceptibility Mapping study in the deep grey matter. Eur J Radiol 2020; 133:109394. [PMID: 33190103 DOI: 10.1016/j.ejrad.2020.109394] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 10/30/2020] [Indexed: 02/09/2023]
Abstract
PURPOSE The aim of the study is to quantify the susceptibility in deep grey nuclei that are affected by pathological processes related to iron accumulation in patients with Parkinson's disease and primary atypical parkinsonisms such as Progressive Supranuclear Palsy, Multiple System Atrophy and Cortico-Basal Degeneration, in order to assist the differential diagnosis among parkinsonian syndromes. METHODS We enrolled 49 patients with Parkinson's disease and 26 patients with primary atypical parkinsonisms. Automatic segmentation of putamen, globus pallidus, caudate nucleus and thalamus and manual segmentation of red nuclei and substantia nigra were performed, and region of interest-based Quantitative Susceptibility Mapping analysis were performed. Statistical comparisons of the mean susceptibility values in the segmented brain regions were performed among primary atypical parkinsonisms and Parkinson's disease. RESULTS Susceptibility values in red nuclei were increased in Progressive Supranuclear Palsy patients compared to parkinsonian phenotype Multiple System Atrophy (p = 0.004), and Parkinson's disease patients (p = 0.006). Susceptibility in thalamus was decreased in Cortico-Basal Degeneration patients compared to Parkinson's disease (p = 0.006), Multiple System Atrophy with cerebellar phenotype (p = 0.031) and parkinsonian phenotype (p = 0.001) patients, and in Progressive Supranuclear Palsy patients compared to Multiple System Atrophy with parkinsonian phenotype patients (p = 0.012). CONCLUSIONS Quantitative Susceptibility Mapping allows the depiction and quantification of different patterns of iron deposition in the deep gray nuclei occurring in primary atypical parkinsonisms and Parkinson's disease and it may help as a non-invasive tool in the differential diagnosis between parkinsonian syndromes.
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Affiliation(s)
- Maria Paola Fedeli
- Radiology Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Valeria Elisa Contarino
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neuroradiology Unit, Milan, Italy.
| | - Silvia Siggillino
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neuroradiology Unit, Milan, Italy
| | - Nina Samoylova
- Faculty of Medicine and Surgery, Università degli Studi di Milano, Milan, Italy
| | - Sonia Calloni
- San Raffaele Scientific Institute, Department of Neuroradiology, Milan, Italy
| | - Luca Melazzini
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Giorgio Conte
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neuroradiology Unit, Milan, Italy
| | | | - Gianni Pezzoli
- Parkinson Institute, ASST 'Gaetano Pini-CTO', Milan, Italy; Fondazione Grigioni per il Morbo di Parkinson, Milan, Italy
| | - Fabio Maria Triulzi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neuroradiology Unit, Milan, Italy; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Italy
| | - Elisa Scola
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neuroradiology Unit, Milan, Italy
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16
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Wang N, Liu XL, Li L, Zuo CT, Wang J, Wu PY, Zhang Y, Liu F, Li Y. Screening for Early-Stage Parkinson's Disease: Swallow Tail Sign on MRI Susceptibility Map-Weighted Images Compared With PET. J Magn Reson Imaging 2020; 53:722-730. [PMID: 33096586 DOI: 10.1002/jmri.27386] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 09/19/2020] [Accepted: 09/22/2020] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Swallow tail sign (STS) on MRI is presumed to be an imaging biomarker of nigrosome-1, which may exhibit a similar role as positron emission tomography (PET), indicating dopaminergic degeneration. PURPOSE To investigate whether an alteration of STS could serve as an alternative screening sign compared with PET in the diagnosis of early-stage Parkinson's disease (esPD). STUDY TYPE Prospective. POPULATION Thirty-seven patients with esPD and 27 age- and sex-matched healthy controls (HCs). FIELD STRENGTH/SEQUENCE Quantitative susceptibility mapping images were collected on 3T MRI and [18 F]9-fluoropropyl-(+)-dihydrotetra-benazine PET images were acquired using a 64 rings PET/CT scanner. ASSESSMENT Alterations of STS and striatal uptake in each hemisphere were visually rated on a 0-2 points scale. Point 2: normal appearance of STS/normal striatal uptake; Point 1: partial loss of STS/uptake reduction confined to the putamen; Point 0: total loss of STS/uptake reduction extended to the caudate nucleus. The concordance rate of STS rating and ipsilateral striatal binding was calculated at the nuclei level. At the participant level, an evaluation rating was calculated by adding the STS ratings from both hemispheres to distinguish esPD from HCs. STATISTICAL TESTS The intra- and interobserver agreement were tested using Cohen's kappa and the intraclass correlation coefficient. Hotelling's T-squared test was used to compare the difference of rating points. Receiver operating characteristic analysis was performed to evaluate the diagnostic power. RESULTS The intra- and interobserver agreement for STS and striatal uptake rating was over 0.75. There was no significant difference of rating point distribution (P = 0.084). The concordance rate was 94.3% for the right side and 91.4% for the left. Using bilateral partial loss of STS as the threshold, the achieved sensitivity and specificity for discriminating esPD from HCs were 94.59% and 92.49%, respectively. DATA CONCLUSION STS alterations corresponded well with striatal uptake on PET in esPD, and our proposed evaluation scale of STS had satisfactory diagnostic performance in discriminating the disease. LEVEL OF EVIDENCE 2 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Na Wang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xue-Ling Liu
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Ling Li
- Department of PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Chuan-Tao Zuo
- Department of PET Center, Huashan Hospital, Fudan University, Shanghai, China
| | - Jian Wang
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | | | | | - Fengtao Liu
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - YuXin Li
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
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17
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Kathuria H, Mehta S, Ahuja CK, Chakravarty K, Ray S, Mittal BR, Singh P, Lal V. Utility of Imaging of Nigrosome-1 on 3T MRI and Its Comparison with 18F-DOPA PET in the Diagnosis of Idiopathic Parkinson Disease and Atypical Parkinsonism. Mov Disord Clin Pract 2020; 8:224-230. [PMID: 33553492 DOI: 10.1002/mdc3.13091] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 07/25/2020] [Accepted: 09/03/2020] [Indexed: 12/16/2022] Open
Abstract
Background Loss of nigrosome-1 on 3T and 7T magnetic resonance imaging (MRI) is a recently explored imaging biomarker in the diagnosis of neurodegenerative parkinsonism. Objectives This study was undertaken to evaluate the utility of imaging of nigrosome in the diagnosis of neurodegenerative parkinsonism on 3T MRI. Methods An institution-based prospective case-control study was conducted at a tertiary care center in North India. 3T venous blood oxygen level-dependent (VenoBOLD) and high-resolution susceptibility-weighted imaging (SWI) imaging sequences in MRI were performed in 100 patients with parkinsonism (56 with idiopathic Parkinson's disease [IPD], 30 with young onset Parkinson's disease [YOPD], 12 with progressive supranuclear palsy, and 2 patients with multiple system atrophy) and 15 controls. Grading of nigrosome was done in both the sequences. Each patient underwent 18F-DOPA positron emission tomography (PET), detailed neurological examination including Hoen and Yahr (H&Y) staging and Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) scoring. Results The diagnostic sensitivity and specificity of the detection of loss of nigrosome-1 on VenoBOLD and SWI sequence at 3T MR imaging were 90% and 66.7% and 94% and 80%, respectively. A weak negative correlation was found between the grading of the nigrosome and clinical parameters (H&Y and UPDRS III). There was no correlation between the side of nigrosome loss and clinical asymmetry. However, nigrosome imaging was not able to differentiate between Parkinson's disease and atypical parkinsonism. Conclusions The loss of nigrosome-1 on 3T MRI on SWI and VenoBOLD sequences may serve as a potential imaging marker in the diagnosis of degenerative parkinsonian syndromes. However, it cannot differentiate between idiopathic Parkinson's disease and atypical parkinsonian syndromes.
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Affiliation(s)
- Heena Kathuria
- Department of Neurology Post Graduate Institute of Medical Education and Research Chandigarh India
| | - Sahil Mehta
- Department of Neurology Post Graduate Institute of Medical Education and Research Chandigarh India
| | - Chirag K Ahuja
- Department of Radiodiagnosis Post Graduate Institute of Medical Education and Research Chandigarh India
| | - Kamalesh Chakravarty
- Department of Neurology Post Graduate Institute of Medical Education and Research Chandigarh India
| | - Sucharita Ray
- Department of Neurology Post Graduate Institute of Medical Education and Research Chandigarh India
| | - Bhagwant Rai Mittal
- Department of Nuclear Medicine Post Graduate Institute of Medical Education and Research Chandigarh India
| | - Paramjeet Singh
- Department of Radiodiagnosis Post Graduate Institute of Medical Education and Research Chandigarh India
| | - Vivek Lal
- Department of Neurology Post Graduate Institute of Medical Education and Research Chandigarh India
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18
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Diagnostic accuracy of the appearance of Nigrosome-1 on magnetic resonance imaging in Parkinson's disease: A systematic review and meta-analysis. Parkinsonism Relat Disord 2020; 78:12-20. [DOI: 10.1016/j.parkreldis.2020.07.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 06/04/2020] [Accepted: 07/02/2020] [Indexed: 02/06/2023]
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19
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Cheng L, Wu X, Guo R, Wang Y, Wang W, He P, Lin H, Shen J. Discriminative pattern of reduced cerebral blood flow in Parkinson's disease and Parkinsonism-Plus syndrome: an ASL-MRI study. BMC Med Imaging 2020; 20:78. [PMID: 32660445 PMCID: PMC7359235 DOI: 10.1186/s12880-020-00479-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 07/06/2020] [Indexed: 11/16/2022] Open
Abstract
Background Accurate identification of Parkinson’s disease (PD) and Parkinsonism-Plus syndrome (PPS), especially in the early stage of the disease, is very important. The purpose of this study was to investigate the discriminative spatial pattern of cerebral blood flow (CBF) between patients with PD and PPS. Methods Arterial spin labeling (ASL) perfusion-weighted imaging was performed in 20 patients with PD (mean age 56.35 ± 7.56 years), 16 patients with PPS (mean age 59.62 ± 6.89 years), and 17 healthy controls (HCs, mean age 54.17 ± 6.58 years). Voxel-wise comparison of the CBF was performed among PD, PPS, and HC groups. The receiver operating characteristic (ROC) curve was used to evaluate the performance of CBF in discriminating between PD and PPS. The relationship between CBF and non-motor neuropsychological scores was assessed by correlation analysis. Results PD group showed a significantly decreased CBF in the right cerebelum_crus2, the left middle frontal gyrus (MFG), the triangle inferior frontal gyrus (IFG_Tri), the left frontal medial orbital gyrus (FG_Med_Orb) and the left caudate nucleus (CN) compared with the HC group (P < 0.05). Besides the above regions, the left supplementary motor area (SMA), the right thalamus had decreased CBF in the PPS group compared with the HC group (P < 0.05). PPS group had lower CBF value in the left MFG, the left IFG_Tri, the left CN, the left SMA, and the right thalamus compared with the PD group (P < 0.05). CBFs in left IFG_Tri, the left CN, the left SMA, and the right thalamus had moderate to high capacity in discriminating between PD and PPS patients (AUC 0.719–0.831). The CBF was positively correlated with the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores in PD patients, while positively correlated with the MMSE, Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) scores in PPS patients (P < 0.05). Conclusion PD and PPS patients have certain discriminative patterns of reduced CBFs, which can be used as a surrogate marker for differential diagnosis.
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Affiliation(s)
- Lina Cheng
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.,Department of Radiology, Guangdong 999 Brain Hospital, Guangzhou, 510510, China
| | - Xiaoyan Wu
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China
| | - Ruomi Guo
- Department of Radiology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510630, China
| | - Yuzhou Wang
- Department of Neurology, Guangdong 999 Brain Hospital, Guangzhou, 510510, China
| | - Wensheng Wang
- Department of Radiology, Guangdong 999 Brain Hospital, Guangzhou, 510510, China
| | - Peng He
- Department of Radiology, Guangdong 999 Brain Hospital, Guangzhou, 510510, China
| | - Hanbo Lin
- Department of Radiology, Guangdong 999 Brain Hospital, Guangzhou, 510510, China
| | - Jun Shen
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, China.
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Biomarkers for Parkinson's Disease: How Good Are They? Neurosci Bull 2019; 36:183-194. [PMID: 31646434 DOI: 10.1007/s12264-019-00433-1] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 09/17/2019] [Indexed: 12/13/2022] Open
Abstract
Parkinson's disease (PD) is a complex neurodegenerative disorder with no cure in sight. Clinical challenges of the disease include the inability to make a definitive diagnosis at the early stages and difficulties in predicting the disease progression. The unmet demand to identify reliable biomarkers for early diagnosis and management of the disease course of PD has attracted a lot of attention. However, only a few reported candidate biomarkers have been tried in clinical practice at the present time. Studies on PD biomarkers have often overemphasized the discovery of novel identity, whereas efforts to further evaluate such candidates are rare. Therefore, we update the new development of biomarker discovery in PD and discuss the standard process in the evaluation and assessment of the diagnostic or prognostic value of the identified potential PD biomarkers in this review article. Recent developments in combined biomarkers and the current status of clinical trials of biomarkers as outcome measures are also discussed. We believe that the combination of different biomarkers might enhance the specificity and sensitivity over a single measure that might not be sufficient for such a multiplex disease.
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