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Chau MT, Agzarian M, Wilcox RA, Dwyer A, Bezak E, Todd G. Simple quantitative planimetric measurement of nigrosome-1 for clinical settings. J Neurol Sci 2023; 454:120857. [PMID: 37939625 DOI: 10.1016/j.jns.2023.120857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/22/2023] [Accepted: 10/26/2023] [Indexed: 11/10/2023]
Abstract
INTRODUCTION Loss of MRI hyperintense signal in nigrosome-1 (assessed with susceptibility-weighted imaging) is a biomarker for Parkinson's disease (PD). Current clinical practice involves subjectively rating the appearance of nigrosome-1 which is challenging. The study aimed to test and compare a simple method for quantifying nigrosome-1 with the current subjective rating method. METHODS Two experienced neuroradiologists measured area of hyperintense signal in nigrosome-1 (quantitative method) and rated nigrosome-1 appearance (as normal, attenuated, or absent; subjective method) in 42 patients encompassing the full spectrum of nigrosome-1 integrity (21 patients aged 55.5 ± 20.9 years with Essential tremor (ET) and a subset of 21 patients aged 69.6 ± 8.6 years with PD). Neuroradiologists were blinded to each other's measurements, clinical notes, and patient group. RESULTS Both methods yielded a significant difference between the groups (PD vs ET; p < 0.001). Pooled (across sides) area of nigrosome-1 hyperintense signal was significantly smaller in the PD group (median = 2.1 mm2, range = 0-15.8 mm2) than ET group (median = 8.3 mm2, range = 0-15.7 mm2; p < 0.001). Inter-rater reliability was high to very high for both methods (subjective: weighted kappa = 0.640, p < 0.001; quantitative: W = 0.733, p = 0.004). Our primary hypothesis that area of nigrosome-1 hyperintense signal exhibits higher inter-rater reliability than subjective rating of nigrosome-1 appearance was not supported. CONCLUSION The simple quantitative method, used with subjectively rated nigrosome-1 appearance, may improve confidence in longitudinal clinical reporting, when nigrosome-1 is attenuated. However, further work on the incremental diagnostic value of planimetry and bias, repeatability and reproducibility are needed before it can be recommended in clinical practice.
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Affiliation(s)
- Minh T Chau
- UniSA Allied Health & Human Performance and Alliance for Research in Exercise, Nutrition and Activity (ARENA), City East Campus, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia; South Australia Medical Imaging, Flinders Medical Centre, 1 Flinders Drive, Bedford Park, SA 5042, Australia
| | - Marc Agzarian
- South Australia Medical Imaging, Flinders Medical Centre, 1 Flinders Drive, Bedford Park, SA 5042, Australia; College of Medicine and Public Health, Flinders University, 1 Flinders Drive, Bedford Park, SA 5042, Australia
| | - Robert A Wilcox
- College of Medicine and Public Health, Flinders University, 1 Flinders Drive, Bedford Park, SA 5042, Australia; Neurology Department, Flinders Medical Centre, 1 Flinders Drive, Bedford Park, SA 5042, Australia; UniSA Clinical & Health Sciences and Alliance for Research in Exercise, Nutrition and Activity (ARENA), City East Campus, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia
| | - Andrew Dwyer
- South Australia Medical Imaging, Flinders Medical Centre, 1 Flinders Drive, Bedford Park, SA 5042, Australia; College of Medicine and Public Health, Flinders University, 1 Flinders Drive, Bedford Park, SA 5042, Australia; Clinical and Research Imaging Centre, South Australian Health and Medical Research Institute, PO Box 11060, Adelaide, SA 5000, Australia
| | - Eva Bezak
- UniSA Allied Health & Human Performance and Alliance for Research in Exercise, Nutrition and Activity (ARENA), City East Campus, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia
| | - Gabrielle Todd
- UniSA Clinical & Health Sciences and Alliance for Research in Exercise, Nutrition and Activity (ARENA), City East Campus, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia.
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Park CH, Shin NY, Yoo SW, Seo H, Yoon U, Yoo JY, Ahn K, Kim JS. Simulating the progression of brain structural alterations in Parkinson's disease. NPJ Parkinsons Dis 2022; 8:86. [PMID: 35764657 PMCID: PMC9240031 DOI: 10.1038/s41531-022-00349-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 06/10/2022] [Indexed: 12/01/2022] Open
Abstract
Considering brain structural alterations as neurodegenerative consequences of Parkinson's disease (PD), we sought to infer the progression of PD via the ordering of brain structural alterations from cross-sectional MRI observations. Having measured cortical thinning in gray matter (GM) regions and disintegrity in white matter (WM) regions as MRI markers of structural alterations for 130 patients with PD (69 ± 10 years, 72 men), stochastic simulation based on the probabilistic relationship between the brain regions was conducted to infer the ordering of structural alterations across all brain regions and the staging of structural alterations according to changes in clinical status. The ordering of structural alterations represented WM disintegrity tending to occur earlier than cortical thinning. The staging of structural alterations indicated structural alterations happening mostly before major disease complications such as postural instability and dementia. Later disease states predicted by the sequence of structural alterations were significantly related to more severe clinical symptoms. The relevance of the ordering of brain structural alterations to the severity of clinical symptoms suggests the clinical feasibility of predicting PD progression states.
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Affiliation(s)
- Chang-Hyun Park
- Department of Radiology, College of Medicine, Catholic University of Korea, Seoul, Korea.,Center for Neuroprosthetics and Brain Mind Institute, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
| | - Na-Young Shin
- Department of Radiology, College of Medicine, Catholic University of Korea, Seoul, Korea.
| | - Sang-Won Yoo
- Department of Neurology, College of Medicine, Catholic University of Korea, Seoul, Korea
| | - Haeseok Seo
- Department of Biomedical Engineering, College of Bio and Medical Sciences, Daegu Catholic University, Gyeongsan, Gyeongbuk, Korea
| | - Uicheul Yoon
- Department of Biomedical Engineering, College of Bio and Medical Sciences, Daegu Catholic University, Gyeongsan, Gyeongbuk, Korea
| | - Ji-Yeon Yoo
- Department of Neurology, College of Medicine, Catholic University of Korea, Seoul, Korea
| | - Kookjin Ahn
- Department of Radiology, College of Medicine, Catholic University of Korea, Seoul, Korea
| | - Joong-Seok Kim
- Department of Neurology, College of Medicine, Catholic University of Korea, Seoul, Korea
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