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Ozgen MN, Sahin NE, Ertan N, Sahin B. Investigation of total cerebellar and flocculonodular lobe volume in Parkinson's disease and healthy individuals: a brain segmentation study. Neurol Sci 2024; 45:4291-4298. [PMID: 38622454 PMCID: PMC11306710 DOI: 10.1007/s10072-024-07509-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 03/30/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Parkinson's disease (PD) is a neurodegenerative disorder with an unexplored link to the cerebellum. In the pathophysiology of balance disorders in PD, the role of the flocculonodular lobe (FL) is linked to the impairment of the dopaminergic system. Dopamine deficiency can also lead to changes in cerebellum functions, disrupting balance control. This study compares cerebellar and FL volumes between healthy controls (HC) and PD patients, analyzing their correlation with clinical outcomes. METHODS We used magnetic resonance images of 23 PD patients (14 male, 9 female) and 24 HC (9 male, 15 female). Intracranial (ICV), total cerebellar, FL, and cerebellar gray matter volumes were measured using VolBrain. Clinical outcomes in PD patients were assessed using the Unified Parkinson's Disease Rating Scale (UPDRS-III) to evaluate motor function, with scores correlated to volumetric data. RESULTS The cerebellar and gray matter volumes in HC were 115.53 ± 10.44 cm3 and 84.83 ± 7.76 cm3, respectively, compared to 126.83 ± 13.47 cm3 and 92.37 ± 9.45 cm3 in PD patients, indicating significantly larger volumes in PD patients (p < 0.05). The flocculonodular lobe gray matter volume was 1.14 ± 0.19 cm3 in PD patients and 1.02 ± 0.13 cm3 in HC, but there was a significant increase in gray matter volume in PD patients between the groups (p < 0.05). In PD patients, significant negative correlations were observed between FL volume and the UPDRS-III scores (r = - 0.467, p = 0.033) and between UPDRS-III scores and both total (r = - 0.453, p = 0.039) and normalized (r = - 0.468, p = 0.032) gray matter volumes of the FL. CONCLUSION Although total gray matter volumes were larger in PD patients, the volumes of FL did not differ between groups. In Parkinson's disease, increased cerebellar volume may regulate fine motor movements rather than balance.
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Affiliation(s)
- Merve Nur Ozgen
- Department of Anatomy, Faculty of Medicine, Tokat Gaziosmanpaşa University, Tokat, Türkiye
| | - Necati Emre Sahin
- Department of Anatomy, Faculty of Medicine, Karabük University, Karabük, Türkiye
| | - Nurcan Ertan
- Radiology Clinic, Ankara Etlik City Hospital, Ankara, Türkiye
| | - Bunyamin Sahin
- Department of Anatomy, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Türkiye.
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Moon HC, Kim A, Park YS. Brain structure comparison among Parkinson disease, essential tremor, and healthy controls using 7T MRI. Medicine (Baltimore) 2024; 103:e38139. [PMID: 38728497 PMCID: PMC11081548 DOI: 10.1097/md.0000000000038139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 04/15/2024] [Indexed: 05/12/2024] Open
Abstract
Both Parkinson disease (PD) and Essential tremor (ET) are movement disorders causing tremors in elderly individuals. Although PD and ET are different disease, they often present with similar initial symptoms, making their differentiation challenging with magnetic resonance imaging (MRI) techniques. This study aimed to identify structural brain differences among PD, ET, and health controls (HCs) using 7-Tesla (T) MRI. We assessed the whole-brain parcellation in gray matter volume, thickness, subcortical volume, and small regions of basal ganglia in PD (n = 18), ET (n = 15), and HCs (n = 18), who were matched for age and sex. Brain structure analysis was performed automatic segmentation through Freesurfer software. Small regions of basal ganglia were manually segmented by ITK-SNAP. Additionally, we examined the associations between clinical indicators (symptom duration, unified Parkinson diseases rating scale (UPDRS), and clinical rating scale for tremor (CRST)) and brain structure. PD showed a significant reduction in gray matter volume in the postcentral region compared to ET. ET showed a significant reduction in cerebellum volume compared to HCs. There was a negative correlation between CRST scores (B and C) and gray matter thickness in right superior frontal in ET. This study demonstrated potential of 7T MRI in differentiating brain structure differences among PD, ET, and HCs. Specific findings, such as parietal lobe atrophy in PD compared to ET and cerebellum atrophy in ET compared to HCs, the importance of advanced imaging techniques in accurately diagnosing and distinguishing between movement disorders that present with similar initial symptoms.
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Affiliation(s)
- Hyeong Cheol Moon
- Department of Neurosurgery, Gamma Knife Icon Center, Chungbuk National University Hospital, Cheongju, Republic of Korea
| | - Aryun Kim
- Department of Neurology, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
| | - Young Seok Park
- Department of Neurosurgery, Gamma Knife Icon Center, Chungbuk National University Hospital, Cheongju, Republic of Korea
- Department of Neurosurgery, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
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Yang W, Bai X, Guan X, Zhou C, Guo T, Wu J, Xu X, Zhang M, Zhang B, Pu J, Tian J. The longitudinal volumetric and shape changes of subcortical nuclei in Parkinson's disease. Sci Rep 2024; 14:7494. [PMID: 38553518 PMCID: PMC10980751 DOI: 10.1038/s41598-024-58187-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/26/2024] [Indexed: 04/02/2024] Open
Abstract
Brain structural changes in Parkinson's disease (PD) are progressive throughout the disease course. Changes in surface morphology with disease progression remain unclear. This study aimed to assess the volumetric and shape changes of the subcortical nuclei during disease progression and explore their association with clinical symptoms. Thirty-four patients and 32 healthy controls were enrolled. The global volume and shape of the subcortical nuclei were compared between patients and controls at baseline. The volume and shape changes of the subcortical nuclei were also explored between baseline and 2 years of follow-up. Association analysis was performed between the volume of subcortical structures and clinical symptoms. In patients with PD, there were significantly atrophied areas in the left pallidum and left putamen, while in healthy controls, the right putamen was dilated compared to baseline. The local morphology of the left pallidum was correlated with Mini Mental State Examination scores. The left putamen shape variation was negatively correlated with changes in Unified Parkinson's Disease Rating Scale PART III scores. Local morphological atrophy of the putamen and pallidum is an important pathophysiological change in the development of PD, and is associated with motor symptoms and cognitive status in patients with PD.
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Affiliation(s)
- Wenyi Yang
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, People's Republic of China
| | - Xueqin Bai
- Department of Radiology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, People's Republic of China
| | - Xiaojun Guan
- Department of Radiology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, People's Republic of China
| | - Cheng Zhou
- Department of Radiology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, People's Republic of China
| | - Tao Guo
- Department of Radiology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, People's Republic of China
| | - Jingjing Wu
- Department of Radiology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, People's Republic of China
| | - Xiaojun Xu
- Department of Radiology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, People's Republic of China
| | - Minming Zhang
- Department of Radiology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, People's Republic of China
| | - Baorong Zhang
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, People's Republic of China
| | - Jiali Pu
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, People's Republic of China
| | - Jun Tian
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang, People's Republic of China.
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Say B, Bayar Muluk N, İnal M, Göncüoğlu A, Yörübulut S, Ergün U. Evaluation of putamen area and cerebral peduncle with surrounding cistern in patients with Parkinson's disease: is there a difference from controls in cranial MRI? Neurol Res 2024; 46:220-226. [PMID: 37953510 DOI: 10.1080/01616412.2023.2281088] [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: 07/16/2023] [Accepted: 11/04/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVES Nigrostriatal dopaminergic neuron loss is essential in pathogenesis of Parkinson's disease (PD). The purpose of this study was to evaluate nigrostriatal structures including the putamen, cerebral peduncle, widths of interpeduncular cistern, and ambient cistern around the midbrain with conventional cranial magnetic resonance images (MRI) in patients with PD. METHODS The MRI of 56 subjects was included, which was selected from the radiological data system for this retrospective study. The 29 patients with idiopathic PD were included and their disease duration, Hoehn&Yahr stage, and Levodopa equivalent dose (LED) were recorded. The 27 controls had a normal neurologic examination and cranial MRI. All subjects in the patient and control groups had right-hand dominance. Putamen and cerebral peduncle areas and widths of interpeduncular and ambient cisterns were measured in T2 sequences of MRI. Further statistical analysis was applied to exclude gender and age effect on areas. RESULTS The areas of putamen and cerebral peduncles were significantly reduced in patients with PD compared to the control bilaterally (p < 0.001). Enlargement of interpeduncular and ambient cisterns in patients was higher than in controls, and it was significant (p < 0.001). A correlation was not observed between measurement results and clinical characteristics of patients with PD. Only the cerebral peduncle area/ambient cistern width ratio was significantly correlated with disease duration positively (right r = 0.46 p = 0.012, left r = 0.389 p = 0.037). CONCLUSION Clinicians should be careful with conventional MRIs of patients with idiopathic PD in practice. It may be different from controls without any neurological disorder, particularly putamen, cerebral peduncles, interpeduncular, and ambient cisterns.
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Affiliation(s)
- Bahar Say
- Faculty of Medicine, Neurology Department, Kırıkkale University, Kırıkkale, Turkey
| | - Nuray Bayar Muluk
- Faculty of Medicine, ENT Department, Kırıkkale University, Kırıkkale, Turkey
| | - Mikail İnal
- Faculty of Medicine, Radiology Department, Kırıkkale University, Kırıkkale, Turkey
| | - Alper Göncüoğlu
- Faculty of Medicine, Radiology Department, Kırıkkale University, Kırıkkale, Turkey
| | - Serap Yörübulut
- Faculty of Science and Literature, Statistics Department, Kırıkkale University, Kırıkkale, Turkey
| | - Ufuk Ergün
- Faculty of Medicine, Neurology Department, Kırıkkale University, Kırıkkale, Turkey
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Ye Z, Zeng Q, Ning L, Huang W, Su Q. Systolic blood pressure is associated with abnormal alterations in brain cortical structure: Evidence from a Mendelian randomization study. Eur J Intern Med 2024; 120:92-98. [PMID: 37852841 DOI: 10.1016/j.ejim.2023.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 09/09/2023] [Accepted: 10/13/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Hypertension has been recognized as a significant risk factor for cerebrovascular diseases and cognitive decline. However, the specific impact of hypertension, systolic/diastolic blood pressure, pulse pressure (PP) and mean arterial pressure (MAP) on brain cortical structure remains unclear. Mendelian randomization (MR) provides a robust approach to investigate the causal relationship between blood pressure components and brain cortical changes. METHODS In this MR study, data from large-scale genome-wide association studies for blood pressure components and neuroimaging were utilized to conduct our analyses. We leveraged genetic variants associated specifically with hypertension (122,620 cases and 332,683 controls), systolic (469,767 individuals), diastolic (490,469 individuals) blood pressure, PP (810,865 individuals) and MAP (over 1 million individuals) to evaluate their effects on brain cortex surficial area (51,665 individuals) and cortex thickness (51,665 individuals). RESULTS Our findings revealed a significant correlation between systolic blood pressure and abnormal reduction in brain cortex surficial area (β=-1330.69, 95% confident interval [CI]: -2655.35 to -6.02, p = 0.0489); however, no significant relationship was found between systolic blood pressure and brain cortex thickness (β=-0.0078, 95% CI: -0.0178 to 0.0022, p = 0.1287). Additionally, no significant associations were observed between hypertension (β=-200.05, p = 0.6884; β=-0.0051, p = 0.1179, respectively), diastolic blood pressure (β=-460.63, p = 0.5160; β=0.0047, p = 0.2448, respectively), PP (β=1041.84, p = 0.3725; β=-0.0112, p = 0.2212, respectively), MAP (β=-18.84, p = 0.8841; β=0.0002, p = 0.7654, respectively) and both brain cortex surficial area and brain cortex thickness. CONCLUSION Our MR study provides evidence supporting the hypothesis that systolic blood pressure, rather than diastolic blood pressure, PP or MAP, is associated with abnormal changes in brain cortical structure.
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Affiliation(s)
- Ziliang Ye
- Department of Cardiology, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, No. 85 Hedi Road, Nanning, Guangxi 530021, China
| | - Qing Zeng
- Department of Cardiology, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, No. 85 Hedi Road, Nanning, Guangxi 530021, China
| | - Limeng Ning
- Department of Cardiology, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, No. 85 Hedi Road, Nanning, Guangxi 530021, China
| | - Wanzhong Huang
- Department of Cardiology, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, No. 85 Hedi Road, Nanning, Guangxi 530021, China
| | - Qiang Su
- Department of Cardiology, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, No. 85 Hedi Road, Nanning, Guangxi 530021, China.
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Kim J, Young GS, Willett AS, Pitaro AT, Crotty GF, Mesidor M, Jones KA, Bay C, Zhang M, Feany MB, Xu X, Qin L, Khurana V. Toward More Accessible Fully Automated 3D Volumetric MRI Decision Trees for the Differential Diagnosis of Multiple System Atrophy, Related Disorders, and Age-Matched Healthy Subjects. CEREBELLUM (LONDON, ENGLAND) 2023; 22:1098-1108. [PMID: 36156185 PMCID: PMC10657274 DOI: 10.1007/s12311-022-01472-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/27/2022] [Indexed: 06/16/2023]
Abstract
Differentiating multiple system atrophy (MSA) from related neurodegenerative movement disorders (NMD) is challenging. MRI is widely available and automated decision-tree analysis is simple, transparent, and resistant to overfitting. Using a retrospective cohort of heterogeneous clinical MRIs broadly sourced from a tertiary hospital system, we aimed to develop readily translatable and fully automated volumetric diagnostic decision-trees to facilitate early and accurate differential diagnosis of NMDs. 3DT1 MRI from 171 NMD patients (72 MSA, 49 PSP, 50 PD) and 171 matched healthy subjects were automatically segmented using Freesurfer6.0 with brainstem module. Decision trees employing substructure volumes and a novel volumetric pons-to-midbrain ratio (3D-PMR) were produced and tenfold cross-validation performed. The optimal tree separating NMD from healthy subjects selected cerebellar white matter, thalamus, putamen, striatum, and midbrain volumes as nodes. Its sensitivity was 84%, specificity 94%, accuracy 84%, and kappa 0.69 in cross-validation. The optimal tree restricted to NMD patients selected 3D-PMR, thalamus, superior cerebellar peduncle (SCP), midbrain, pons, and putamen as nodes. It yielded sensitivities/specificities of 94/84% for MSA, 72/96% for PSP, and 73/92% PD, with 79% accuracy and 0.62 kappa. There was correct classification of 16/17 MSA, 5/8 PSP, 6/8 PD autopsy-confirmed patients, and 6/8 MRIs that preceded motor symptom onset. Fully automated decision trees utilizing volumetric MRI data distinguished NMD patients from healthy subjects and MSA from other NMDs with promising accuracy, including autopsy-confirmed and pre-symptomatic subsets. Our open-source methodology is well-suited for widespread clinical translation. Assessment in even more heterogeneous retrospective and prospective cohorts is indicated.
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Affiliation(s)
- Jisoo Kim
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Geoffrey S Young
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Andrew S Willett
- Division of Movement Disorders, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Ariana T Pitaro
- Division of Movement Disorders, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Grace F Crotty
- Division of Movement Disorders, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, USA
| | - Merlyne Mesidor
- Division of Movement Disorders, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Kristie A Jones
- Division of Movement Disorders, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Camden Bay
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Min Zhang
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Mel B Feany
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Xiaoyin Xu
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Lei Qin
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
- Department of Imaging, Dana-Farber Cancer Institute, Boston, MA, 02115, USA
| | - Vikram Khurana
- Division of Movement Disorders, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA.
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA.
- Ann Romney Center for Neurologic Diseases, Brigham and Women's Hospital, Boston, MA, 02115, USA.
- Hale Building for Transformative Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA.
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Purrer V, Pohl E, Lueckel JM, Borger V, Sauer M, Radbruch A, Wüllner U, Schmeel FC. Artificial-intelligence-based MRI brain volumetry in patients with essential tremor and tremor-dominant Parkinson's disease. Brain Commun 2023; 5:fcad271. [PMID: 37946794 PMCID: PMC10631860 DOI: 10.1093/braincomms/fcad271] [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: 05/06/2023] [Revised: 08/02/2023] [Accepted: 10/12/2023] [Indexed: 11/12/2023] Open
Abstract
Essential tremor and Parkinson's disease patients may present with various tremor types. Overlapping tremor features can be challenging to diagnosis and misdiagnosis is common. Although underlying neurodegenerative mechanisms are suggested, neuroimaging studies arrived at controversial results and often the different tremor types were not considered. We investigated whether different tremor types displayed distinct structural brain features. Structural MRI of 61 patients with essential tremor and 29 with tremor-dominant Parkinson's disease was analysed using a fully automated artificial-intelligence-based brain volumetry to compare volumes of several cortical and subcortical regions. Furthermore, essential tremor subgroups with and without rest tremor or more pronounced postural and kinetic tremor were investigated. Deviations from an internal reference collective of age- and sex-adjusted healthy controls and volumetric differences between groups were examined; regression analysis was used to determine the contribution of disease-related factors on volumetric measurements. Compared with healthy controls, essential tremor and tremor-dominant Parkinson's disease patients displayed deviations in the occipital lobes, hippocampus, putamen, pallidum and mesencephalon while essential tremor patients exhibited decreased volumes within the nucleus caudatus and thalamus. Analysis of covariance revealed similar volumetric patterns in both diseases. Essential tremor patients without rest tremor showed a significant atrophy within the thalamus compared to tremor-dominant Parkinson's disease and atrophy of the mesencephalon and putamen were found in both subgroups compared to essential tremor with rest tremor. Disease-related factors contribute to volumes of occipital lobes in both diseases and to volumes of temporal lobes in essential tremor and the putamen in Parkinson's disease. Fully automated artificial-intelligence-based volumetry provides a fast and rater-independent method to investigate brain volumes in different neurological disorders and allows comparisons with an internal reference collective. Our results indicate that essential tremor and tremor-dominant Parkinson's disease share structural changes, indicative of neurodegenerative mechanisms, particularly of the basal-ganglia-thalamocortical circuitry. A discriminating, possibly disease-specific involvement of the thalamus was found in essential tremor patients without rest tremor and the mesencephalon and putamen in tremor-dominant Parkinson's disease and essential tremor without rest tremor.
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Affiliation(s)
- Veronika Purrer
- Department of Neurology, University Hospital Bonn, 53127 Bonn, Germany
- German Center of Neurodegenerative Diseases (DZNE), 53127 Bonn, Germany
| | - Emily Pohl
- Department of Neurology, University Hospital Bonn, 53127 Bonn, Germany
| | - Julia M Lueckel
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, 53127 Bonn, Germany
| | - Valeri Borger
- Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, Germany
| | - Malte Sauer
- Department of Neuroradiology, University Hospital Bonn, 53127 Bonn, Germany
| | - Alexander Radbruch
- German Center of Neurodegenerative Diseases (DZNE), 53127 Bonn, Germany
- Department of Neuroradiology, University Hospital Bonn, 53127 Bonn, Germany
| | - Ullrich Wüllner
- Department of Neurology, University Hospital Bonn, 53127 Bonn, Germany
- German Center of Neurodegenerative Diseases (DZNE), 53127 Bonn, Germany
| | - Frederic Carsten Schmeel
- German Center of Neurodegenerative Diseases (DZNE), 53127 Bonn, Germany
- Department of Neuroradiology, University Hospital Bonn, 53127 Bonn, Germany
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Erlinger M, Molina-Ruiz R, Brumby A, Cordas D, Hunter M, Ferreiro Arguelles C, Yus M, Owens-Walton C, Jakabek D, Shaw M, Lopez Valdes E, Looi JCL. Striatal and thalamic automatic segmentation, morphology, and clinical correlates in Parkinsonism: Parkinson's disease, multiple system atrophy and progressive supranuclear palsy. Psychiatry Res Neuroimaging 2023; 335:111719. [PMID: 37806261 DOI: 10.1016/j.pscychresns.2023.111719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/20/2023] [Accepted: 09/23/2023] [Indexed: 10/10/2023]
Abstract
Parkinson's disease (PD), multisystem atrophy (MSA), and progressive supranuclear palsy (PSP) present similarly with bradykinesia, tremor, rigidity, and cognitive impairments. Neuroimaging studies have found differential changes in the nigrostriatal pathway in these disorders, however whether the volume and shape of specific regions within this pathway can distinguish between atypical Parkinsonian disorders remains to be determined. This paper investigates striatal and thalamic volume and morphology as distinguishing biomarkers, and their relationship to neuropsychiatric symptoms. Automatic segmentation to calculate volume and shape analysis of the caudate nucleus, putamen, and thalamus were performed in 18 PD patients, 12 MSA, 15 PSP, and 20 healthy controls, then correlated with clinical measures. PSP bilateral thalami and right putamen were significantly smaller than controls, but not MSA or PD. The left caudate and putamen significantly correlated with the Neuropsychiatric Inventory total score. Bilateral thalamus, caudate, and left putamen had significantly different morphology between groups, driven by differences between PSP and healthy controls. This study demonstrated that PSP patient striatal and thalamic volume and shape are significantly different when compared with controls. Parkinsonian disorders could not be differentiated on volumetry or morphology, however there are trends for volumetric and morphological changes associated with PD, MSA, and PSP.
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Affiliation(s)
- M Erlinger
- Research Centre for the Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, School of Clinical Medicine, Australian National University, Canberra, Australia.
| | | | - A Brumby
- Research Centre for the Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, School of Clinical Medicine, Australian National University, Canberra, Australia
| | - D Cordas
- Research Centre for the Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, School of Clinical Medicine, Australian National University, Canberra, Australia
| | - M Hunter
- Research Centre for the Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, School of Clinical Medicine, Australian National University, Canberra, Australia
| | | | - M Yus
- Hospital Clinico San Carlos, Madrid, Spain
| | - C Owens-Walton
- Research Centre for the Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, School of Clinical Medicine, Australian National University, Canberra, Australia
| | - D Jakabek
- Neuroscience Research Australia, Sydney, Australia
| | - M Shaw
- Hospital Clinico San Carlos, Madrid, Spain
| | | | - J C L Looi
- Research Centre for the Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, School of Clinical Medicine, Australian National University, Canberra, Australia
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9
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Seada SA, van der Eerden AW, Boon AJW, Hernandez-Tamames JA. Quantitative MRI protocol and decision model for a 'one stop shop' early-stage Parkinsonism diagnosis: Study design. Neuroimage Clin 2023; 39:103506. [PMID: 37696098 PMCID: PMC10500558 DOI: 10.1016/j.nicl.2023.103506] [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: 03/30/2023] [Revised: 06/21/2023] [Accepted: 09/04/2023] [Indexed: 09/13/2023]
Abstract
Differentiating among early-stage parkinsonisms is a challenge in clinical practice. Quantitative MRI can aid the diagnostic process, but studies with singular MRI techniques have had limited success thus far. Our objective is to develop a multi-modal MRI method for this purpose. In this review we describe existing methods and present a dedicated quantitative MRI protocol, a decision model and a study design to validate our approach ahead of a pilot study. We present example imaging data from patients and a healthy control, which resemble related literature.
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Affiliation(s)
- Samy Abo Seada
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Anke W van der Eerden
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Agnita J W Boon
- Department of Neurology, Erasmus MC, Rotterdam, The Netherlands
| | - Juan A Hernandez-Tamames
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands; Department of Imaging Physics, TU Delft, The Netherlands.
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10
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Deng JH, Zhang HW, Liu XL, Deng HZ, Lin F. Morphological changes in Parkinson's disease based on magnetic resonance imaging: A mini-review of subcortical structures segmentation and shape analysis. World J Psychiatry 2022; 12:1356-1366. [PMID: 36579355 PMCID: PMC9791612 DOI: 10.5498/wjp.v12.i12.1356] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/02/2022] [Accepted: 11/22/2022] [Indexed: 12/16/2022] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder caused by the loss of dopaminergic neurons in the substantia nigra, resulting in clinical symptoms, including bradykinesia, resting tremor, rigidity, and postural instability. The pathophysiological changes in PD are inextricably linked to the subcortical structures. Shape analysis is a method for quantifying the volume or surface morphology of structures using magnetic resonance imaging. In this review, we discuss the recent advances in morphological analysis techniques for studying the subcortical structures in PD in vivo. This approach includes available pipelines for volume and shape analysis, focusing on the morphological features of volume and surface area.
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Affiliation(s)
- Jin-Huan Deng
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People’s Hospital, Shenzhen 518035, Guangdong Province, China
| | - Han-Wen Zhang
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People’s Hospital, Shenzhen 518035, Guangdong Province, China
| | - Xiao-Lei Liu
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People’s Hospital, Shenzhen 518035, Guangdong Province, China
| | - Hua-Zhen Deng
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People’s Hospital, Shenzhen 518035, Guangdong Province, China
| | - Fan Lin
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People’s Hospital, Shenzhen 518035, Guangdong Province, China
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11
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Youn J, Kim M, Park S, Kim JS, Park H, Cho JW. Pallidal Structural Changes Related to Levodopa-induced Dyskinesia in Parkinson's Disease. Front Aging Neurosci 2022; 14:781883. [PMID: 35601615 PMCID: PMC9120819 DOI: 10.3389/fnagi.2022.781883] [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: 09/23/2021] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundDespite the clinical impact of levodopa-induced dyskinesia (LID) in Parkinson's disease (PD), the mechanism, especially the role of basal ganglia (BG), is not fully elucidated yet. We investigated the BG structural changes related to LID in PD using a surface-based shape analysis technique.MethodsWe recruited patients with PD who developed LID within 3 years (LID group, 28 patients) and who did not develop it after 7 years (non-LID group, 35 patients) from levodopa treatment for the extreme case-control study. BG structure volumes were measured using volumetry analysis and the surface-based morphometry feature (i.e., Jacobian) from the subcortical surface vertices. We compared the volume and Jacobian of meshes in the regions between the two groups. We also performed a correlation analysis between local atrophy and the severity of LID. Additionally, we evaluated structural connectivity profiles from globus pallidus interna and externa (GPi and GPe) to other brain structures based on the group comparison.ResultsThe demographic and clinical data showed no significant difference except for disease duration, treatment duration, parkinsonism severity, and levodopa equivalent dose. The LID group had more local atrophies of vertices in the right GPi than the non-LID group, despite no difference in volumes. Furthermore, the LID group demonstrated significantly reduced structural connectivity between left GPi and thalamus.ConclusionThis is the first demonstration of distinct shape alterations of basal ganglia structures, especially GPi, related to LID in PD. Considering both direct and indirect BG pathways share the connection between GPi and thalamus, the BG pathway plays a crucial role in the development of LID.
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12
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Quattrone A, Bianco MG, Antonini A, Vaillancourt DE, Seppi K, Ceravolo R, Strafella AP, Tedeschi G, Tessitore A, Cilia R, Morelli M, Nigro S, Vescio B, Arcuri PP, De Micco R, Cirillo M, Weis L, Fiorenzato E, Biundo R, Burciu RG, Krismer F, McFarland NR, Mueller C, Gizewski ER, Cosottini M, Del Prete E, Mazzucchi S, Quattrone A. Development and Validation of Automated
Magnetic Resonance
Parkinsonism Index 2.0 to Distinguish
Progressive Supranuclear Palsy‐Parkinsonism
From
Parkinson's Disease. Mov Disord 2022; 37:1272-1281. [PMID: 35403258 PMCID: PMC9321546 DOI: 10.1002/mds.28992] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/21/2022] [Accepted: 02/23/2022] [Indexed: 12/11/2022] Open
Abstract
Background Differentiating progressive supranuclear palsy‐parkinsonism (PSP‐P) from Parkinson's disease (PD) is clinically challenging. Objective This study aimed to develop an automated Magnetic Resonance Parkinsonism Index 2.0 (MRPI 2.0) algorithm to distinguish PSP‐P from PD and to validate its diagnostic performance in two large independent cohorts. Methods We enrolled 676 participants: a training cohort (n = 346; 43 PSP‐P, 194 PD, and 109 control subjects) from our center and an independent testing cohort (n = 330; 62 PSP‐P, 171 PD, and 97 control subjects) from an international research group. We developed a new in‐house algorithm for MRPI 2.0 calculation and assessed its performance in distinguishing PSP‐P from PD and control subjects in both cohorts using receiver operating characteristic curves. Results The automated MRPI 2.0 showed excellent performance in differentiating patients with PSP‐P from patients with PD and control subjects both in the training cohort (area under the receiver operating characteristic curve [AUC] = 0.93 [95% confidence interval, 0.89–0.98] and AUC = 0.97 [0.93–1.00], respectively) and in the international testing cohort (PSP‐P versus PD, AUC = 0.92 [0.87–0.97]; PSP‐P versus controls, AUC = 0.94 [0.90–0.98]), suggesting the generalizability of the results. The automated MRPI 2.0 also accurately distinguished between PSP‐P and PD in the early stage of the diseases (AUC = 0.91 [0.84–0.97]). A strong correlation (r = 0.91, P < 0.001) was found between automated and manual MRPI 2.0 values. Conclusions Our study provides an automated, validated, and generalizable magnetic resonance biomarker to distinguish PSP‐P from PD. The use of the automated MRPI 2.0 algorithm rather than manual measurements could be important to standardize measures in patients with PSP‐P across centers, with a positive impact on multicenter studies and clinical trials involving patients from different geographic regions. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
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Affiliation(s)
- Andrea Quattrone
- Institute of Neurology, University “Magna Graecia” Catanzaro Italy
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology University College London London United Kingdom
| | - Maria G. Bianco
- Department of Medical and Surgical Sciences University “Magna Graecia” Catanzaro Italy
- Neuroscience Research Center University “Magna Graecia” Catanzaro Italy
| | - Angelo Antonini
- Parkinson and Movement Disorders Unit, Study Center for Neurodegeneration CESNE, Department of Neuroscience University of Padua Padua Italy
| | - David E. Vaillancourt
- Department of Applied Physiology and Kinesiology University of Florida Gainesville Florida USA
- Department of Neurology and Biomedical Engineering University of Florida Gainesville Florida USA
| | - Klaus Seppi
- Department of Neurology Medical University Innsbruck Innsbruck Austria
- Neuroimaging Core Facility Medical University Innsbruck Innsbruck Austria
| | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine, Center for NeuroDegenerative Diseases University of Pisa Pisa Italy
| | - Antonio P. Strafella
- Krembil Brain Institute, UHN & Research Imaging Center, Campbell Family Mental Health Research Institute, CAMH University of Toronto Toronto Ontario Canada
| | - Gioacchino Tedeschi
- Department of Advanced Medical and Surgical Sciences University of Campania “Luigi Vanvitelli” Naples Italy
- MRI Research Center SUN‐FISM University of Campania “Luigi Vanvitelli” Naples Italy
| | - Alessandro Tessitore
- Department of Advanced Medical and Surgical Sciences University of Campania “Luigi Vanvitelli” Naples Italy
- MRI Research Center SUN‐FISM University of Campania “Luigi Vanvitelli” Naples Italy
| | - Roberto Cilia
- Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta Parkinson and Movement Disorders Unit Milan Italy
| | - Maurizio Morelli
- Institute of Neurology, University “Magna Graecia” Catanzaro Italy
| | - Salvatore Nigro
- Institute of Nanotechnology (NANOTEC) National Research Council Lecce Italy
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico" Tricase Italy
| | - Basilio Vescio
- Institute of Molecular Bioimaging and Physiology National Research Council (IBFM‐CNR) Catanzaro Italy
| | | | - Rosa De Micco
- Department of Advanced Medical and Surgical Sciences University of Campania “Luigi Vanvitelli” Naples Italy
- MRI Research Center SUN‐FISM University of Campania “Luigi Vanvitelli” Naples Italy
| | - Mario Cirillo
- Department of Advanced Medical and Surgical Sciences University of Campania “Luigi Vanvitelli” Naples Italy
- MRI Research Center SUN‐FISM University of Campania “Luigi Vanvitelli” Naples Italy
| | - Luca Weis
- Parkinson and Movement Disorders Unit, Study Center for Neurodegeneration CESNE, Department of Neuroscience University of Padua Padua Italy
| | | | - Roberta Biundo
- Department of General Psychology University of Padua Padua Italy
| | - Roxana G. Burciu
- Department of Kinesiology and Applied Physiology University of Delaware Newark Delaware USA
| | - Florian Krismer
- Department of Neurology Medical University Innsbruck Innsbruck Austria
- Neuroimaging Core Facility Medical University Innsbruck Innsbruck Austria
| | - Nikolaus R. McFarland
- Department of Neurology and Biomedical Engineering University of Florida Gainesville Florida USA
| | - Christoph Mueller
- Department of Neurology Medical University Innsbruck Innsbruck Austria
| | - Elke R. Gizewski
- Neuroimaging Core Facility Medical University Innsbruck Innsbruck Austria
- Department of Neuroradiology Medical University Innsbruck Innsbruck Austria
| | - Mirco Cosottini
- Department of Translational Research and New Technologies University of Pisa Pisa Italy
| | - Eleonora Del Prete
- Department of Clinical and Experimental Medicine, Center for NeuroDegenerative Diseases University of Pisa Pisa Italy
| | - Sonia Mazzucchi
- Department of Clinical and Experimental Medicine, Center for NeuroDegenerative Diseases University of Pisa Pisa Italy
| | - Aldo Quattrone
- Neuroscience Research Center University “Magna Graecia” Catanzaro Italy
- Institute of Molecular Bioimaging and Physiology National Research Council (IBFM‐CNR) Catanzaro Italy
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13
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Filip P, Bednarik P, Eberly LE, Moheet A, Svatkova A, Grohn H, Kumar AF, Seaquist ER, Mangia S. Different FreeSurfer versions might generate different statistical outcomes in case-control comparison studies. Neuroradiology 2022; 64:765-773. [PMID: 34988592 DOI: 10.1007/s00234-021-02862-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/12/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Neuroimaging pipelines have long been known to generate mildly differing results depending on various factors, including software version. While considered generally acceptable and within the margin of reasonable error, little is known about their effect in common research scenarios such as inter-group comparisons between healthy controls and various pathological conditions. The aim of the presented study was to explore the differences in the inferences and statistical significances in a model situation comparing volumetric parameters between healthy controls and type 1 diabetes patients using various FreeSurfer versions. METHODS T1- and T2-weighted structural scans of healthy controls and type 1 diabetes patients were processed with FreeSurfer 5.3, FreeSurfer 5.3 HCP, FreeSurfer 6.0 and FreeSurfer 7.1, followed by inter-group statistical comparison using outputs of individual FreeSurfer versions. RESULTS Worryingly, FreeSurfer 5.3 detected both cortical and subcortical volume differences out of the preselected regions of interest, but newer versions such as FreeSurfer 5.3 HCP and FreeSurfer 6.0 reported only subcortical differences of lower magnitude and FreeSurfer 7.1 failed to find any statistically significant inter-group differences. CONCLUSION Since group averages of individual FreeSurfer versions closely matched, in keeping with previous literature, the main origin of this disparity seemed to lie in substantially higher within-group variability in the model pathological condition. Ergo, until validation in common research scenarios as case-control comparison studies is included into the development process of new software suites, confirmatory analyses utilising a similar software based on analogous, but not fully equivalent principles, might be considered as supplement to careful quality control.
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Affiliation(s)
- Pavel Filip
- Center for Magnetic Resonance Research (CMRR), University of Minnesota, 2021 Sixth St. SE, Minneapolis, MN, 55455, USA.,Department of Neurology, Charles University, First Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Petr Bednarik
- Center for Magnetic Resonance Research (CMRR), University of Minnesota, 2021 Sixth St. SE, Minneapolis, MN, 55455, USA.,High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Lynn E Eberly
- Center for Magnetic Resonance Research (CMRR), University of Minnesota, 2021 Sixth St. SE, Minneapolis, MN, 55455, USA.,Division of Biostatistics, School of Public Health, University of Minnesota, Minnesota, MN, USA
| | - Amir Moheet
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Alena Svatkova
- Department of Medicine III, Clinical Division of Endocrinology and Metabolism, Medical University of Vienna, Vienna, Austria.,Department of Imaging Methods, Faculty of Medicine, University of Ostrava, Ostrava, Czechia
| | - Heidi Grohn
- Center for Magnetic Resonance Research (CMRR), University of Minnesota, 2021 Sixth St. SE, Minneapolis, MN, 55455, USA.,Diagnostic Imaging Center, Kuopio University Hospital, Kuopio, Finland
| | - Anjali F Kumar
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | | | - Silvia Mangia
- Center for Magnetic Resonance Research (CMRR), University of Minnesota, 2021 Sixth St. SE, Minneapolis, MN, 55455, USA.
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14
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Scotton WJ, Bocchetta M, Todd E, Cash DM, Oxtoby N, VandeVrede L, Heuer H, Alexander DC, Rowe JB, Morris HR, Boxer A, Rohrer JD, Wijeratne PA. A data-driven model of brain volume changes in progressive supranuclear palsy. Brain Commun 2022; 4:fcac098. [PMID: 35602649 PMCID: PMC9118104 DOI: 10.1093/braincomms/fcac098] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 12/08/2021] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
The most common clinical phenotype of progressive supranuclear palsy is Richardson syndrome, characterized by levodopa unresponsive symmetric parkinsonism, with a vertical supranuclear gaze palsy, early falls and cognitive impairment. There is currently no detailed understanding of the full sequence of disease pathophysiology in progressive supranuclear palsy. Determining the sequence of brain atrophy in progressive supranuclear palsy could provide important insights into the mechanisms of disease progression, as well as guide patient stratification and monitoring for clinical trials. We used a probabilistic event-based model applied to cross-sectional structural MRI scans in a large international cohort, to determine the sequence of brain atrophy in clinically diagnosed progressive supranuclear palsy Richardson syndrome. A total of 341 people with Richardson syndrome (of whom 255 had 12-month follow-up imaging) and 260 controls were included in the study. We used a combination of 12-month follow-up MRI scans, and a validated clinical rating score (progressive supranuclear palsy rating scale) to demonstrate the longitudinal consistency and utility of the event-based model's staging system. The event-based model estimated that the earliest atrophy occurs in the brainstem and subcortical regions followed by progression caudally into the superior cerebellar peduncle and deep cerebellar nuclei, and rostrally to the cortex. The sequence of cortical atrophy progresses in an anterior to posterior direction, beginning in the insula and then the frontal lobe before spreading to the temporal, parietal and finally the occipital lobe. This in vivo ordering accords with the post-mortem neuropathological staging of progressive supranuclear palsy and was robust under cross-validation. Using longitudinal information from 12-month follow-up scans, we demonstrate that subjects consistently move to later stages over this time interval, supporting the validity of the model. In addition, both clinical severity (progressive supranuclear palsy rating scale) and disease duration were significantly correlated with the predicted subject event-based model stage (P < 0.01). Our results provide new insights into the sequence of atrophy progression in progressive supranuclear palsy and offer potential utility to stratify people with this disease on entry into clinical trials based on disease stage, as well as track disease progression.
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Affiliation(s)
- W. J. Scotton
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen
Square Institute of Neurology, University College London, London, UK
- Correspondence to: William J. Scotton UCL Institute of Neurology
Department of Neurodegeneration Dementia Research Centre First Floor, 8-11 Queen Square,
WC1N 3AR London, UK E-mail:
| | - M. Bocchetta
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen
Square Institute of Neurology, University College London, London, UK
| | - E. Todd
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen
Square Institute of Neurology, University College London, London, UK
| | - D. M. Cash
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen
Square Institute of Neurology, University College London, London, UK
| | - N. Oxtoby
- Centre for Medical Image Computing, Department of Computer Science, University
College London, London, UK
| | - L. VandeVrede
- Department of Neurology, Memory and Aging Center, University of
California, San Francisco, CA, USA
| | - H. Heuer
- Department of Neurology, Memory and Aging Center, University of
California, San Francisco, CA, USA
| | | | - D. C. Alexander
- Centre for Medical Image Computing, Department of Computer Science, University
College London, London, UK
| | - J. B. Rowe
- Department of Clinical Neurosciences, Cambridge University, Cambridge
University Hospitals NHS Trust, Cambridge, UK
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge
University, Cambridge, UK
| | - H. R. Morris
- Department of Clinical and Movement Neurosciences, University College London
Queen Square Institute of Neurology, London, UK
- Movement Disorders Centre, University College London Queen Square Institute of
Neurology, London, UK
| | - A. Boxer
- Department of Neurology, Memory and Aging Center, University of
California, San Francisco, CA, USA
| | - J. D. Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen
Square Institute of Neurology, University College London, London, UK
| | - P. A. Wijeratne
- Centre for Medical Image Computing, Department of Computer Science, University
College London, London, UK
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15
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King G, Veros KM, MacLaren DAA, Leigh MPK, Spernyak JA, Clark SD. Human wildtype tau expression in cholinergic pedunculopontine tegmental neurons is sufficient to produce PSP-like behavioural deficits and neuropathology. Eur J Neurosci 2021; 54:7688-7709. [PMID: 34668254 DOI: 10.1111/ejn.15496] [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] [Received: 08/18/2021] [Revised: 09/30/2021] [Accepted: 10/12/2021] [Indexed: 11/30/2022]
Abstract
Progressive Supranuclear Palsy (PSP) is the most common atypical parkinsonism and exhibits hallmark symptomology including motor function impairment and dysexecutive dementia. In contrast to Parkinson's disease, the underlying pathology displays aggregation of the protein tau, which is also seen in disorders such as Alzheimer's disease. Currently, there are no pharmacological treatments for PSP, and drug discovery efforts are hindered by the lack of an animal model specific to PSP. Based on previous results and clinical pathology, it was hypothesized that viral deposition of tau in cholinergic neurons within the hindbrain would produce a tauopathy along neural connections to produce PSP-like symptomology and pathology. By using a combination of ChAT-CRE rats and CRE-dependent AAV vectors, wildtype human tau (the PSP-relevant 1N4R isoform; hTau) was expressed in hindbrain cholinergic neurons. Compared to control subjects (GFP), rats with tau expression displayed deficits in a variety of behavioural paradigms: acoustic startle reflex, marble burying, horizontal ladder and hindlimb motor reflex. Postmortem, the hTau rats had significantly reduced number of cholinergic pedunculopontine tegmentum and dopaminergic substantia nigra neurons, as well as abnormal tau deposits. This preclinical model has multiple points of convergence with the clinical features of PSP, some of which distinguish between PSP and Parkinson's disease.
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Affiliation(s)
- Gabriella King
- Department of Pharmacology and Toxicology, University at Buffalo, Buffalo, New York, USA
| | - Kaliana M Veros
- Department of Pharmacology and Toxicology, University at Buffalo, Buffalo, New York, USA
| | | | | | - Joseph A Spernyak
- Department of Cell Stress Biology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Stewart D Clark
- Department of Pharmacology and Toxicology, University at Buffalo, Buffalo, New York, USA
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16
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Owens-Walton C, Jakabek D, Power BD, Walterfang M, Hall S, van Westen D, Looi JCL, Shaw M, Hansson O. Structural and functional neuroimaging changes associated with cognitive impairment and dementia in Parkinson's disease. Psychiatry Res Neuroimaging 2021; 312:111273. [PMID: 33892387 DOI: 10.1016/j.pscychresns.2021.111273] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 12/09/2020] [Accepted: 01/12/2021] [Indexed: 12/29/2022]
Abstract
This study seeks a better understanding of possible pathophysiological mechanisms associated with cognitive impairment and dementia in Parkinson's disease using structural and functional MRI. We investigated resting-state functional connectivity of important subdivisions of the caudate nucleus, putamen and thalamus, and also how the morphology of these structures are impacted in the disorder. We found cognitively unimpaired Parkinson's disease subjects (n = 33), compared to controls (n = 26), display increased functional connectivity of the dorsal caudate, anterior putamen and mediodorsal thalamic subdivisions with areas across the frontal lobe, as well as reduced functional connectivity of the dorsal caudate with posterior cortical and cerebellar regions. Compared to cognitively unimpaired subjects, those with mild cognitive impairment (n = 22) demonstrated reduced functional connectivity of the mediodorsal thalamus with the paracingulate cortex, while also demonstrating increased functional connectivity of the mediodorsal thalamus with the posterior cingulate cortex, compared to subjects with dementia (n = 17). Extensive volumetric and surface-based deflation was found in subjects with dementia compared to cognitively unimpaired Parkinson's disease participants and controls. Our research suggests that structures within basal ganglia-thalamocortical circuits are implicated in cognitive impairment and dementia in Parkinson's disease, with cognitive impairment and dementia associated with a breakdown in functional connectivity of the mediodorsal thalamus with para- and posterior cingulate regions of the brain respectively.
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Affiliation(s)
- Conor Owens-Walton
- Research Centre for the Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, School of Clinical Medicine, Medical School, Australian National University, Canberra, Australia.
| | - David Jakabek
- Graduate School of Medicine, University of Wollongong, Wollongong, Australia
| | - Brian D Power
- School of Medicine, The University of Notre Dame, Fremantle, Australia; Clinical Research Centre, North Metropolitan Health Service - Mental Health, Perth, Australia
| | - Mark Walterfang
- Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia; Florey Institute of Neurosciences and Mental Health, University of Melbourne, Melbourne, Australia
| | - Sara Hall
- Memory Clinic, Skåne University Hospital, Malmö, Sweden; Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Danielle van Westen
- Centre for Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden; Diagnostic Radiology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Jeffrey C L Looi
- Research Centre for the Neurosciences of Ageing, Academic Unit of Psychiatry and Addiction Medicine, School of Clinical Medicine, Medical School, Australian National University, Canberra, Australia; Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Marnie Shaw
- College of Engineering and Computer Science, The Australian National University, Canberra, Australia
| | - Oskar Hansson
- Memory Clinic, Skåne University Hospital, Malmö, Sweden; Department of Clinical Sciences, Lund University, Malmö, Sweden
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17
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Bae YJ, Kim JM, Sohn CH, Choi JH, Choi BS, Song YS, Nam Y, Cho SJ, Jeon B, Kim JH. Imaging the Substantia Nigra in Parkinson Disease and Other Parkinsonian Syndromes. Radiology 2021; 300:260-278. [PMID: 34100679 DOI: 10.1148/radiol.2021203341] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Parkinson disease is characterized by dopaminergic cell loss in the substantia nigra of the midbrain. There are various imaging markers for Parkinson disease. Recent advances in MRI have enabled elucidation of the underlying pathophysiologic changes in the nigral structure. This has contributed to accurate and early diagnosis and has improved disease progression monitoring. This article aims to review recent developments in nigral imaging for Parkinson disease and other parkinsonian syndromes, including nigrosome imaging, neuromelanin imaging, quantitative iron mapping, and diffusion-tensor imaging. In particular, this article examines nigrosome imaging using 7-T MRI and 3-T susceptibility-weighted imaging. Finally, this article discusses volumetry and its clinical importance related to symptom manifestation. This review will improve understanding of recent advancements in nigral imaging of Parkinson disease. Published under a CC BY 4.0 license.
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Affiliation(s)
- Yun Jung Bae
- From the Departments of Radiology (Y.J.B., B.S.C., S.J.C., J.H.K.), Neurology (J.M.K., J.H.C.), and Nuclear Medicine (Y.S.S.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea; Departments of Radiology (C.H.S.) and Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; and Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.)
| | - Jong-Min Kim
- From the Departments of Radiology (Y.J.B., B.S.C., S.J.C., J.H.K.), Neurology (J.M.K., J.H.C.), and Nuclear Medicine (Y.S.S.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea; Departments of Radiology (C.H.S.) and Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; and Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.)
| | - Chul-Ho Sohn
- From the Departments of Radiology (Y.J.B., B.S.C., S.J.C., J.H.K.), Neurology (J.M.K., J.H.C.), and Nuclear Medicine (Y.S.S.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea; Departments of Radiology (C.H.S.) and Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; and Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.)
| | - Ji-Hyun Choi
- From the Departments of Radiology (Y.J.B., B.S.C., S.J.C., J.H.K.), Neurology (J.M.K., J.H.C.), and Nuclear Medicine (Y.S.S.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea; Departments of Radiology (C.H.S.) and Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; and Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.)
| | - Byung Se Choi
- From the Departments of Radiology (Y.J.B., B.S.C., S.J.C., J.H.K.), Neurology (J.M.K., J.H.C.), and Nuclear Medicine (Y.S.S.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea; Departments of Radiology (C.H.S.) and Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; and Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.)
| | - Yoo Sung Song
- From the Departments of Radiology (Y.J.B., B.S.C., S.J.C., J.H.K.), Neurology (J.M.K., J.H.C.), and Nuclear Medicine (Y.S.S.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea; Departments of Radiology (C.H.S.) and Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; and Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.)
| | - Yoonho Nam
- From the Departments of Radiology (Y.J.B., B.S.C., S.J.C., J.H.K.), Neurology (J.M.K., J.H.C.), and Nuclear Medicine (Y.S.S.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea; Departments of Radiology (C.H.S.) and Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; and Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.)
| | - Se Jin Cho
- From the Departments of Radiology (Y.J.B., B.S.C., S.J.C., J.H.K.), Neurology (J.M.K., J.H.C.), and Nuclear Medicine (Y.S.S.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea; Departments of Radiology (C.H.S.) and Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; and Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.)
| | - Beomseok Jeon
- From the Departments of Radiology (Y.J.B., B.S.C., S.J.C., J.H.K.), Neurology (J.M.K., J.H.C.), and Nuclear Medicine (Y.S.S.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea; Departments of Radiology (C.H.S.) and Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; and Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.)
| | - Jae Hyoung Kim
- From the Departments of Radiology (Y.J.B., B.S.C., S.J.C., J.H.K.), Neurology (J.M.K., J.H.C.), and Nuclear Medicine (Y.S.S.), Seoul National University Bundang Hospital, Seoul National University College of Medicine, 173-82 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Republic of Korea; Departments of Radiology (C.H.S.) and Neurology (B.J.), Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea; and Division of Biomedical Engineering, Hankuk University of Foreign Studies, Yongin, Republic of Korea (Y.N.)
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18
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Talai AS, Sedlacik J, Boelmans K, Forkert ND. Utility of Multi-Modal MRI for Differentiating of Parkinson's Disease and Progressive Supranuclear Palsy Using Machine Learning. Front Neurol 2021; 12:648548. [PMID: 33935946 PMCID: PMC8079721 DOI: 10.3389/fneur.2021.648548] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 03/22/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Patients with Parkinson's disease (PD) and progressive supranuclear palsy Richardson's syndrome (PSP-RS) often show overlapping clinical features, leading to misdiagnoses. The objective of this study was to investigate the feasibility and utility of using multi-modal MRI datasets for an automatic differentiation of PD patients, PSP-RS patients, and healthy control (HC) subjects. Material and Methods: T1-weighted, T2-weighted, and diffusion-tensor (DTI) MRI datasets from 45 PD patients, 20 PSP-RS patients, and 38 HC subjects were available for this study. Using an atlas-based approach, regional values of brain morphology (T1-weighted), brain iron metabolism (T2-weighted), and microstructural integrity (DTI) were measured and employed for feature selection and subsequent classification using combinations of various established machine learning methods. Results: The optimal machine learning model using regional morphology features only achieved a classification accuracy of 65% (67/103 correct classifications) differentiating PD patients, PSP-RS patients, and HC subjects. The optimal machine learning model using only quantitative T2 values performed slightly better and achieved an accuracy of 75.7% (78/103). The optimal classifier using DTI features alone performed considerably better with 95.1% accuracy (98/103). The optimal multi-modal classifier using all features also achieved an accuracy of 95.1% but required more features and achieved a slightly lower F1-score compared to the optimal model using DTI features alone. Conclusion: Machine learning models using multi-modal MRI perform significantly better than uni-modal machine learning models using morphological parameters based on T1-weighted MRI datasets alone or brain iron metabolism markers based on T2-weighted MRI datasets alone. However, machine learnig models using regional brain microstructural integrity metrics computed from DTI datasets perform similar to the optimal multi-modal machine learning model. Thus, given the results from this study cohort, it appears that morphology and brain iron metabolism markers may not provide additional value for classification compared to using DTI metrics alone.
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Affiliation(s)
- Aron S. Talai
- Department of Radiology, University of Calgary, Calgary, AB, Canada
| | - Jan Sedlacik
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kai Boelmans
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
- Department of Neurology, Klinikum Bremerhaven-Reinkenheide, Bremerhaven, Germany
| | - Nils D. Forkert
- Department of Radiology, University of Calgary, Calgary, AB, Canada
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19
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Lin J, Xu X, Hou Y, Yang J, Shang H. Voxel-Based Meta-Analysis of Gray Matter Abnormalities in Multiple System Atrophy. Front Aging Neurosci 2020; 12:591666. [PMID: 33328969 PMCID: PMC7729009 DOI: 10.3389/fnagi.2020.591666] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 10/28/2020] [Indexed: 02/05/2023] Open
Abstract
Purpose: This study aimed to identify consistent gray matter volume (GMV) changes in the two subtypes of multiple system atrophy (MSA), including parkinsonism subtype (MSA-P), and cerebellar subtype (MSA-C), by conducting a voxel-wise meta-analysis of whole brain voxel-based morphometry (VBM) studies. Method: VBM studies comparing MSA-P or MSA-C and healthy controls (HCs) were systematically searched in the PubMed, Embase, and Web of Science published from 1974 to 20 October 2020. A quantitative meta-analysis of VBM studies on MSA-P or MSA-C was performed using the effect size-based signed differential mapping (ES-SDM) method separately. A complementary analysis was conducted using the Seed-based d Mapping with Permutation of Subject Images (SDM-PSI) method, which allows a familywise error rate (FWE) correction for multiple comparisons of the results, for further validation of the results. Results: Ten studies were included in the meta-analysis of MSA-P subtype, comprising 136 MSA-P patients and 211 HCs. Five studies were included in the meta-analysis of MSA-C subtype, comprising 89 MSA-C patients and 134 HCs. Cerebellum atrophy was detected in both MSA-P and MSA-C, whereas basal ganglia atrophy was only detected in MSA-P. Cerebral cortex atrophy was detected in both subtypes, with predominant impairment of the superior temporal gyrus, inferior frontal gyrus, temporal pole, insula, and amygdala in MSA-P and predominant impairment of the superior temporal gyrus, middle temporal gyrus, fusiform gyrus, and lingual gyrus in MSA-C. Most of these results survived the FWE correction in the complementary analysis, except for the bilateral amygdala and the left caudate nucleus in MSA-P, and the right superior temporal gyrus and the right middle temporal gyrus in MSA-C. These findings remained robust in the jackknife sensitivity analysis, and no significant heterogeneity was detected. Conclusion: A different pattern of brain atrophy between MSA-P and MSA-C detected in the current study was in line with clinical manifestations and provided the evidence of the pathophysiology of the two subtypes of MSA.
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Affiliation(s)
- Junyu Lin
- Laboratory of Neurodegenerative Disorders, Department of Neurology, Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xinran Xu
- Laboratory of Neurodegenerative Disorders, Department of Neurology, Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China
| | - Yanbing Hou
- Laboratory of Neurodegenerative Disorders, Department of Neurology, Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Yang
- Laboratory of Neurodegenerative Disorders, Department of Neurology, Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China
| | - Huifang Shang
- Laboratory of Neurodegenerative Disorders, Department of Neurology, Rare Diseases Center, West China Hospital, Sichuan University, Chengdu, China
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20
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Heim B, Mangesius S, Krismer F, Wenning GK, Hussl A, Scherfler C, Gizewski ER, Schocke M, Esterhammer R, Quattrone A, Poewe W, Seppi K. Diagnostic accuracy of MR planimetry in clinically unclassifiable parkinsonism. Parkinsonism Relat Disord 2020; 82:87-91. [PMID: 33271461 DOI: 10.1016/j.parkreldis.2020.11.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 11/17/2020] [Accepted: 11/20/2020] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Quantitative MR planimetric measurements were reported to discriminate between progressive supranuclear palsy (PSP) and non-PSP parkinsonism, yet few data exist on the usefulness of these markers in early disease stages. METHODS The pons-to-midbrain area ratio (P/M) and the Magnetic Resonance Parkinsonism Index (MRPI) as well as new indices, termed P/M2.0 and MRPI2.0, multiplying the former by a ratio of the third ventricle (3rdV) width/frontal horns (FH) width, were calculated on T1-weighted images in 84 patients with clinically unclassifiable neurodegenerative parkinsonism (CUP) at the time of imaging. Areas under the curve (AUCs) of these markers for predicting future PSP was determined. The final clinical diagnosis was made after at least 24 months of follow-up. RESULTS Final diagnosis was Parkinson's disease in 55 patients, multiple system atrophy in 12 cases, and PSP in 17. At baseline imaging, patients with a final PSP diagnosis had significantly higher MRPI, P/M, MRPI2.0 and P/M2.0 values compared to the other groups. AUCs in discriminating between future PSP and non-PSP parkinsonism were 0.91 for both the P/M and the MRPI and 0.98 for the P/M2.0 and the MRPI2.0. CONCLUSIONS Brainstem-derived MR planimetric measures yield high diagnostic accuracy for separating PSP from non-PSP parkinsonism in early disease stages when clinical criteria are not yet fully met. Consistent with the underlying pathology in PSP, our study suggests that inclusion of 3rdV width makes P/M2.0 and MRPI2.0 more accurate in diagnosing early stage PSP patients than the P/M and MRPI.
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Affiliation(s)
- Beatrice Heim
- Department of Neurology, Medical University of Innsbruck, Austria
| | - Stephanie Mangesius
- Department of Neuroradiology, Medical University Innsbruck, Innsbruck, Austria; Neuroimaging Core Facility, Medical University Innsbruck, Innsbruck, Austria
| | - Florian Krismer
- Department of Neurology, Medical University of Innsbruck, Austria
| | - Gregor K Wenning
- Department of Neurology, Medical University of Innsbruck, Austria
| | - Anna Hussl
- Department of Neurology, Medical University of Innsbruck, Austria
| | - Christoph Scherfler
- Department of Neurology, Medical University of Innsbruck, Austria; Neuroimaging Core Facility, Medical University Innsbruck, Innsbruck, Austria
| | - Elke R Gizewski
- Department of Neuroradiology, Medical University Innsbruck, Innsbruck, Austria; Neuroimaging Core Facility, Medical University Innsbruck, Innsbruck, Austria
| | - Michael Schocke
- Department of Neuroradiology, Medical University Innsbruck, Innsbruck, Austria; Neuroimaging Core Facility, Medical University Innsbruck, Innsbruck, Austria
| | - Regina Esterhammer
- Department of Neuroradiology, Medical University Innsbruck, Innsbruck, Austria
| | - Andrea Quattrone
- Institute of Neurology, Department of Medical Sciences, Magna Graecia University of Catanzaro, Italy
| | - Werner Poewe
- Department of Neurology, Medical University of Innsbruck, Austria; Neuroimaging Core Facility, Medical University Innsbruck, Innsbruck, Austria
| | - Klaus Seppi
- Department of Neurology, Medical University of Innsbruck, Austria; Neuroimaging Core Facility, Medical University Innsbruck, Innsbruck, Austria.
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21
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Quattrone A, Antonini A, Vaillancourt DE, Seppi K, Ceravolo R, Strafella AP, Morelli M, Nigro S, Vescio B, Bianco MG, Vasta R, Arcuri PP, Weis L, Fiorenzato E, Biundo R, Burciu RG, Krismer F, McFarland NR, Mueller C, Gizewski ER, Cosottini M, Del Prete E, Mazzucchi S, Quattrone A. A New MRI Measure to Early Differentiate Progressive Supranuclear Palsy From De Novo Parkinson's Disease in Clinical Practice: An International Study. Mov Disord 2020; 36:681-689. [PMID: 33151015 DOI: 10.1002/mds.28364] [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: 07/08/2020] [Revised: 09/02/2020] [Accepted: 10/12/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Enlargement of the third ventricle has been reported in atypical parkinsonism. We investigated whether the measurement of third ventricle width could distinguish Parkinson's disease (PD) from progressive supranuclear palsy (PSP). METHODS We assessed a new MR T1-weighted measurement (third ventricle width/internal skull diameter) in a training cohort of 268 participants (98 PD, 73 PSP, 98 controls from our center) and in a testing cohort of 291 participants (82 de novo PD patients and 133 controls from the Parkinson's Progression Markers Initiative, 76 early-stage PSP from an international research group). PD diagnosis was confirmed after a 4-year follow-up. Diagnostic performance of the third ventricle/internal skull diameter was assessed using receiver operating characteristic curve with bootstrapping; the area under the curve of the training cohort was compared with the area under the curve of the testing cohort using the De Long test. RESULTS In both cohorts, third ventricle/internal skull diameter values did not differ between PD and controls but were significantly lower in PD than in PSP patients (P < 0.0001). In PD, third ventricle/internal skull diameter values did not change significantly between baseline and follow-up evaluation. Receiver operating characteristic analysis accurately differentiated PD from PSP in the training cohort (area under the curve, 0.94; 95% CI, 91.1-97.6; cutoff, 5.72) and in the testing cohort (area under the curve, 0.91; 95% CI, 87.0-97.0; cutoff,: 5.88), validating the generalizability of the results. CONCLUSION Our study provides a new reliable and validated MRI measurement for the early differentiation of PD and PSP. The simplicity and generalizability of this biomarker make it suitable for routine clinical practice and for selection of patients in clinical trials worldwide. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Andrea Quattrone
- Institute of Neurology, University "Magna Graecia", Catanzaro, Italy
| | - Angelo Antonini
- Department of Neuroscience, University of Padua, Padua, Italy
| | - David E Vaillancourt
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, USA.,Department of Neurology and Biomedical Engineering, University of Florida, Gainesville, Florida, USA
| | - Klaus Seppi
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria.,Neuroimaging Core Facility, Medical University Innsbruck, Innsbruck, Austria
| | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Pisa, Pisa, Italy
| | - Antonio P Strafella
- Krembil Research Institute, UHN & Research Imaging Centre, Campbell Family Mental Health Research Institute, CAMH, University of Toronto, Toronto, Ontario, Canada
| | - Maurizio Morelli
- Institute of Neurology, University "Magna Graecia", Catanzaro, Italy
| | - Salvatore Nigro
- Neuroscience Research Center, University "Magna Graecia", Catanzaro, Italy
| | | | - Maria G Bianco
- Department of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Roberta Vasta
- Neuroscience Research Center, University "Magna Graecia", Catanzaro, Italy
| | - Pier Paolo Arcuri
- Department of Radiology, Pugliese-Ciaccio Hospital, Catanzaro, Italy
| | - Luca Weis
- IRCCS San Camillo Hospital, Venice, Italy
| | | | | | - Roxana G Burciu
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware, USA
| | - Florian Krismer
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Nikolaus R McFarland
- Department of Neurology and Biomedical Engineering, University of Florida, Gainesville, Florida, USA
| | - Christoph Mueller
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Elke R Gizewski
- Neuroimaging Core Facility, Medical University Innsbruck, Innsbruck, Austria.,Department of Neuroradiology, Medical University Innsbruck, Innsbruck, Austria
| | - Mirco Cosottini
- Department of Translational Research and New Technologies, University of Pisa, Pisa, Italy
| | - Eleonora Del Prete
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Pisa, Pisa, Italy
| | - Sonia Mazzucchi
- Department of Clinical and Experimental Medicine, Unit of Neurology, University of Pisa, Pisa, Italy
| | - Aldo Quattrone
- Neuroscience Research Center, University "Magna Graecia", Catanzaro, Italy.,Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Catanzaro, Italy
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22
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Chougar L, Faouzi J, Pyatigorskaya N, Yahia‐Cherif L, Gaurav R, Biondetti E, Villotte M, Valabrègue R, Corvol J, Brice A, Mariani L, Cormier F, Vidailhet M, Dupont G, Piot I, Grabli D, Payan C, Colliot O, Degos B, Lehéricy S. Automated Categorization of Parkinsonian Syndromes Using
Magnetic Resonance Imaging
in a Clinical Setting. Mov Disord 2020; 36:460-470. [DOI: 10.1002/mds.28348] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 09/15/2020] [Indexed: 02/06/2023] Open
Affiliation(s)
- Lydia Chougar
- Paris Brain Institute–ICM, INSERM U 1127, CNRS UMR 7225, Sorbonne Université, UMR S 1127, CNRS UMR 7225 Paris France
- ICM, “Movement Investigations and Therapeutics” Team (MOV'IT) Paris France
- ICM, Centre de NeuroImagerie de Recherche–CENIR Paris France
- Department of Neuroradiology Pitié‐Salpêtrière University Hospital, APHP Paris France
| | - Johann Faouzi
- Paris Brain Institute–ICM, INSERM U 1127, CNRS UMR 7225, Sorbonne Université, UMR S 1127, CNRS UMR 7225 Paris France
- INRIA, Aramis Team Paris France
| | - Nadya Pyatigorskaya
- Paris Brain Institute–ICM, INSERM U 1127, CNRS UMR 7225, Sorbonne Université, UMR S 1127, CNRS UMR 7225 Paris France
- ICM, “Movement Investigations and Therapeutics” Team (MOV'IT) Paris France
- ICM, Centre de NeuroImagerie de Recherche–CENIR Paris France
- Department of Neuroradiology Pitié‐Salpêtrière University Hospital, APHP Paris France
| | - Lydia Yahia‐Cherif
- Paris Brain Institute–ICM, INSERM U 1127, CNRS UMR 7225, Sorbonne Université, UMR S 1127, CNRS UMR 7225 Paris France
- ICM, Centre de NeuroImagerie de Recherche–CENIR Paris France
| | - Rahul Gaurav
- Paris Brain Institute–ICM, INSERM U 1127, CNRS UMR 7225, Sorbonne Université, UMR S 1127, CNRS UMR 7225 Paris France
- ICM, “Movement Investigations and Therapeutics” Team (MOV'IT) Paris France
- ICM, Centre de NeuroImagerie de Recherche–CENIR Paris France
| | - Emma Biondetti
- Paris Brain Institute–ICM, INSERM U 1127, CNRS UMR 7225, Sorbonne Université, UMR S 1127, CNRS UMR 7225 Paris France
- ICM, “Movement Investigations and Therapeutics” Team (MOV'IT) Paris France
- ICM, Centre de NeuroImagerie de Recherche–CENIR Paris France
| | - Marie Villotte
- Faculté de Médecine Université Denis Diderot Paris France
| | - Romain Valabrègue
- Paris Brain Institute–ICM, INSERM U 1127, CNRS UMR 7225, Sorbonne Université, UMR S 1127, CNRS UMR 7225 Paris France
- ICM, Centre de NeuroImagerie de Recherche–CENIR Paris France
| | - Jean‐Christophe Corvol
- Paris Brain Institute–ICM, INSERM U 1127, CNRS UMR 7225, Sorbonne Université, UMR S 1127, CNRS UMR 7225 Paris France
- ICM, Centre d'Investigation Clinique Neurosciences Paris France
| | - Alexis Brice
- Paris Brain Institute–ICM, INSERM U 1127, CNRS UMR 7225, Sorbonne Université, UMR S 1127, CNRS UMR 7225 Paris France
- ICM, Team Neurogénétique Fondamentale et Translationnelle Paris France
| | - Louise‐Laure Mariani
- Paris Brain Institute–ICM, INSERM U 1127, CNRS UMR 7225, Sorbonne Université, UMR S 1127, CNRS UMR 7225 Paris France
- ICM, Centre d'Investigation Clinique Neurosciences Paris France
- Clinique des Mouvements Anormaux, Département des Maladies du Système Nerveux, Hôpital Pitié‐Salpêtrière, APHP Paris France
| | - Florence Cormier
- Clinique des Mouvements Anormaux, Département des Maladies du Système Nerveux, Hôpital Pitié‐Salpêtrière, APHP Paris France
| | - Marie Vidailhet
- Paris Brain Institute–ICM, INSERM U 1127, CNRS UMR 7225, Sorbonne Université, UMR S 1127, CNRS UMR 7225 Paris France
- ICM, “Movement Investigations and Therapeutics” Team (MOV'IT) Paris France
- Clinique des Mouvements Anormaux, Département des Maladies du Système Nerveux, Hôpital Pitié‐Salpêtrière, APHP Paris France
| | - Gwendoline Dupont
- Université de Bourgogne Dijon France
- Centre Hospitalier Universitaire François Mitterrand, Département de Neurologie Dijon France
| | - Ines Piot
- Department of Neuroradiology Pitié‐Salpêtrière University Hospital, APHP Paris France
| | - David Grabli
- Clinique des Mouvements Anormaux, Département des Maladies du Système Nerveux, Hôpital Pitié‐Salpêtrière, APHP Paris France
| | - Christine Payan
- BESPIM, Hôpital Universitaire de Nîmes Nîmes France
- Service de Pharmacologie Clinique, Hôpital Pitié‐Salpêtrière, APHP Paris France
| | - Olivier Colliot
- Paris Brain Institute–ICM, INSERM U 1127, CNRS UMR 7225, Sorbonne Université, UMR S 1127, CNRS UMR 7225 Paris France
- INRIA, Aramis Team Paris France
| | - Bertrand Degos
- Dynamics and Pathophysiology of Neuronal Networks Team, Center for Interdisciplinary Research in Biology Collège de France, CNRS UMR7241/INSERM U1050, MemoLife Labex Paris France
- Department of Neurology, Avicenne University Hospital Sorbonne Paris Nord University Bobigny France
| | - Stéphane Lehéricy
- Paris Brain Institute–ICM, INSERM U 1127, CNRS UMR 7225, Sorbonne Université, UMR S 1127, CNRS UMR 7225 Paris France
- ICM, “Movement Investigations and Therapeutics” Team (MOV'IT) Paris France
- ICM, Centre de NeuroImagerie de Recherche–CENIR Paris France
- Department of Neuroradiology Pitié‐Salpêtrière University Hospital, APHP Paris France
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23
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Park CH, Lee PH, Lee SK, Chung SJ, Shin NY. The diagnostic potential of multimodal neuroimaging measures in Parkinson's disease and atypical parkinsonism. Brain Behav 2020; 10:e01808. [PMID: 33029883 PMCID: PMC7667347 DOI: 10.1002/brb3.1808] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION For the diagnosis of Parkinson's disease (PD) and atypical parkinsonism (AP) using neuroimaging, structural measures have been largely employed since structural abnormalities are most noticeable in the diseases. Functional abnormalities have been known as well, though less clearly seen, and thus, the addition of functional measures to structural measures is expected to be more informative for the diagnosis. Here, we aimed to assess whether multimodal neuroimaging measures of structural and functional alterations could have potential for enhancing performance in diverse diagnostic classification problems. METHODS For 77 patients with PD, 86 patients with AP comprising multiple system atrophy and progressive supranuclear palsy, and 53 healthy controls (HC), structural and functional MRI data were collected. Gray matter (GM) volume was acquired as a structural measure, and GM regional homogeneity and degree centrality were acquired as functional measures. The measures were used as predictors individually or in combination in support vector machine classifiers for different problems of distinguishing between HC and each diagnostic type and between different diagnostic types. RESULTS In statistical comparisons of the measures, structural alterations were extensively seen in all diagnostic types, whereas functional alterations were limited to specific diagnostic types. The addition of functional measures to the structural measure generally yielded statistically significant improvements to classification accuracy, compared to the use of the structural measure alone. CONCLUSION We suggest the fusion of multimodal neuroimaging measures as an effective strategy that could generally cope with diverse prediction problems of clinical concerns.
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Affiliation(s)
- Chang-Hyun Park
- Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Center for Neuroprosthetics and Brain Mind Institute, Swiss Federal Institute of Technology (EPFL), Geneva, Switzerland
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea
| | - Seung-Koo Lee
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.,Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, Korea
| | - Na-Young Shin
- Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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24
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Srinivasan D, Erus G, Doshi J, Wolk DA, Shou H, Habes M, Davatzikos C. A comparison of Freesurfer and multi-atlas MUSE for brain anatomy segmentation: Findings about size and age bias, and inter-scanner stability in multi-site aging studies. Neuroimage 2020; 223:117248. [PMID: 32860881 DOI: 10.1016/j.neuroimage.2020.117248] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 08/04/2020] [Indexed: 12/28/2022] Open
Abstract
Automatic segmentation of brain anatomy has been a key processing step in quantitative neuroimaging analyses. An extensive body of literature has relied on Freesurfer segmentations. Yet, in recent years, the multi-atlas segmentation framework has consistently obtained results with superior accuracy in various evaluations. We compared brain anatomy segmentations from Freesurfer, which uses a single probabilistic atlas strategy, against segmentations from Multi-atlas region Segmentation utilizing Ensembles of registration algorithms and parameters and locally optimal atlas selection (MUSE), one of the leading ensemble-based methods that calculates a consensus segmentation through fusion of anatomical labels from multiple atlases and registrations. The focus of our evaluation was twofold. First, using manual ground-truth hippocampus segmentations, we found that Freesurfer segmentations showed a bias towards over-segmentation of larger hippocampi, and under-segmentation in older age. This bias was more pronounced in Freesurfer-v5.3, which has been used in multiple previous studies of aging, while the effect was mitigated in more recent Freesurfer-v6.0, albeit still present. Second, we evaluated inter-scanner segmentation stability using same day scan pairs from ADNI acquired on 1.5T and 3T scanners. We also found that MUSE obtains more consistent segmentations across scanners compared to Freesurfer, particularly in the deep structures.
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Affiliation(s)
- Dhivya Srinivasan
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Richards Building, 3700 Hamilton Walk, 7th Floor, Philadelphia, PA 19104, United States.
| | - Guray Erus
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Richards Building, 3700 Hamilton Walk, 7th Floor, Philadelphia, PA 19104, United States
| | - Jimit Doshi
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Richards Building, 3700 Hamilton Walk, 7th Floor, Philadelphia, PA 19104, United States
| | - David A Wolk
- Department of Neurology, University of Pennsylvania, United States
| | - Haochang Shou
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Richards Building, 3700 Hamilton Walk, 7th Floor, Philadelphia, PA 19104, United States; Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, United States
| | - Mohamad Habes
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Richards Building, 3700 Hamilton Walk, 7th Floor, Philadelphia, PA 19104, United States; Department of Neurology, University of Pennsylvania, United States
| | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Richards Building, 3700 Hamilton Walk, 7th Floor, Philadelphia, PA 19104, United States
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Wu C. Multi-trait Genome-Wide Analyses of the Brain Imaging Phenotypes in UK Biobank. Genetics 2020; 215:947-958. [PMID: 32540950 PMCID: PMC7404235 DOI: 10.1534/genetics.120.303242] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 06/09/2020] [Indexed: 01/08/2023] Open
Abstract
Many genetic variants identified in genome-wide association studies (GWAS) are associated with multiple, sometimes seemingly unrelated, traits. This motivates multi-trait association analyses, which have successfully identified novel associated loci for many complex diseases. While appealing, most existing methods focus on analyzing a relatively small number of traits, and may yield inflated Type 1 error rates when a large number of traits need to be analyzed jointly. As deep phenotyping data are becoming rapidly available, we develop a novel method, referred to as aMAT (adaptive multi-trait association test), for multi-trait analysis of any number of traits. We applied aMAT to GWAS summary statistics for a set of 58 volumetric imaging derived phenotypes from the UK Biobank. aMAT had a genomic inflation factor of 1.04, indicating the Type 1 error rate was well controlled. More important, aMAT identified 24 distinct risk loci, 13 of which were ignored by standard GWAS. In comparison, the competing methods either had a suspicious genomic inflation factor or identified much fewer risk loci. Finally, four additional sets of traits have been analyzed and provided similar conclusions.
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Affiliation(s)
- Chong Wu
- Department of Statistics, Florida State University, Tallahassee, Florida 32306
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Chougar L, Pyatigorskaya N, Degos B, Grabli D, Lehéricy S. The Role of Magnetic Resonance Imaging for the Diagnosis of Atypical Parkinsonism. Front Neurol 2020; 11:665. [PMID: 32765399 PMCID: PMC7380089 DOI: 10.3389/fneur.2020.00665] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 06/03/2020] [Indexed: 12/14/2022] Open
Abstract
The diagnosis of Parkinson's disease and atypical Parkinsonism remains clinically difficult, especially at the early stage of the disease, since there is a significant overlap of symptoms. Multimodal MRI has significantly improved diagnostic accuracy and understanding of the pathophysiology of Parkinsonian disorders. Structural and quantitative MRI sequences provide biomarkers sensitive to different tissue properties that detect abnormalities specific to each disease and contribute to the diagnosis. Machine learning techniques using these MRI biomarkers can effectively differentiate atypical Parkinsonian syndromes. Such approaches could be implemented in a clinical environment and improve the management of Parkinsonian patients. This review presents different structural and quantitative MRI techniques, their contribution to the differential diagnosis of atypical Parkinsonian disorders and their interest for individual-level diagnosis.
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Affiliation(s)
- Lydia Chougar
- Institut du Cerveau et de la Moelle épinière-ICM, INSERM U 1127, CNRS UMR 7225, Sorbonne Université, UPMC Univ Paris 06, UMRS 1127, CNRS UMR 7225, Paris, France.,ICM, "Movement Investigations and Therapeutics" Team (MOV'IT), Paris, France.,ICM, Centre de NeuroImagerie de Recherche-CENIR, Paris, France.,Service de Neuroradiologie, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Nadya Pyatigorskaya
- Institut du Cerveau et de la Moelle épinière-ICM, INSERM U 1127, CNRS UMR 7225, Sorbonne Université, UPMC Univ Paris 06, UMRS 1127, CNRS UMR 7225, Paris, France.,ICM, "Movement Investigations and Therapeutics" Team (MOV'IT), Paris, France.,ICM, Centre de NeuroImagerie de Recherche-CENIR, Paris, France.,Service de Neuroradiologie, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Bertrand Degos
- Dynamics and Pathophysiology of Neuronal Networks Team, Center for Interdisciplinary Research in Biology, Collège de France, CNRS UMR7241/INSERM U1050, MemoLife Labex, Paris, France.,Department of Neurology, Avicenne University Hospital, Sorbonne Paris Nord University, Bobigny, France
| | - David Grabli
- Département des Maladies du Système Nerveux, Hôpital Pitié-Salpêtrière, APHP, Paris, France
| | - Stéphane Lehéricy
- Institut du Cerveau et de la Moelle épinière-ICM, INSERM U 1127, CNRS UMR 7225, Sorbonne Université, UPMC Univ Paris 06, UMRS 1127, CNRS UMR 7225, Paris, France.,ICM, "Movement Investigations and Therapeutics" Team (MOV'IT), Paris, France.,ICM, Centre de NeuroImagerie de Recherche-CENIR, Paris, France.,Service de Neuroradiologie, Hôpital Pitié-Salpêtrière, APHP, Paris, France
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27
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Quattrone A, Sarica A, La Torre D, Morelli M, Vescio B, Nigro S, Barbagallo G, Nisticò R, Salsone M, Arcuri PP, Novellino F, Bianco MG, Arabia G, Cascini G, Quattrone A. Magnetic Resonance Imaging Biomarkers Distinguish Normal Pressure Hydrocephalus From Progressive Supranuclear Palsy. Mov Disord 2020; 35:1406-1415. [PMID: 32396693 DOI: 10.1002/mds.28087] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 04/08/2020] [Accepted: 04/14/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Idiopathic normal pressure hydrocephalus and PSP share several clinical and radiological features, making differential diagnosis, at times, challenging. OBJECTIVES To differentiate idiopathic normal pressure hydrocephalus from PSP using MR volumetric and linear measurements. METHODS Twenty-seven idiopathic normal pressure hydrocephalus patients, 103 probable PSP patients, and 43 control subjects were consecutively enrolled. Automated ventricular volumetry was performed using Freesurfer 6 on MR T1 -weighted images. Linear measurements, such as callosal angle and a new measure, termed MR Hydrocephalic Index, were calculated on MR T1 -weighted images. Receiver operating characteristic analyses were used for differentiating between patient groups. Generalizability and reproducibility of the results were validated, dividing each participant group in two cohorts used as training and testing subsets. RESULTS Ventricular volumes and linear measurements (callosal angle and Magnetic Resonance Hydrocephalic Index) revealed greater ventricular enlargement in patients with idiopathic normal pressure hydrocephalus than in PSP patients and controls. PSP patients had ventricular volume larger than controls. Automated ventricular volumetry and Magnetic Resonance Hydrocephalic Index were the most accurate measures (98.5%) in differentiating patients with idiopathic normal pressure hydrocephalus from PSP patients, whereas callosal angle misclassified several PSP patients and showed low positive predictive value (70.0%) in differentiating between these two diseases. All measurements accurately differentiated idiopathic normal pressure hydrocephalus patients from controls. Accuracy values obtained in the training set (automated ventricular volumetry, 98.4%; Magnetic Resonance Hydrocephalic Index, 98.4%; callosal angle, 87.5%) were confirmed in the testing set. CONCLUSIONS Our study demonstrates that AVV and Magnetic Resonance Hydrocephalic Index were the most accurate measures for differentiation between idiopathic normal pressure hydrocephalus and PSP patients. Magnetic Resonance Hydrocephalic Index is easy to measure and can be used in clinical practice to prevent misdiagnosis and ineffective shunt procedures in idiopathic normal pressure hydrocephalus mimics. © 2020 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Andrea Quattrone
- Institute of Neurology, University "Magna Graecia", Catanzaro, Italy
| | - Alessia Sarica
- Neuroscience Research Center, University "Magna Graecia", Catanzaro, Italy
| | - Domenico La Torre
- Institute of Neurosurgery, "University Magna Graecia", Catanzaro, Italy
| | - Maurizio Morelli
- Institute of Neurology, University "Magna Graecia", Catanzaro, Italy
| | | | - Salvatore Nigro
- Neuroscience Research Center, University "Magna Graecia", Catanzaro, Italy
| | | | - Rita Nisticò
- Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Catanzaro, Italy
| | - Maria Salsone
- Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Catanzaro, Italy
| | - Pier Paolo Arcuri
- Department of Radiology, Pugliese-Ciaccio Hospital, Catanzaro, Italy
| | - Fabiana Novellino
- Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Catanzaro, Italy
| | | | - Gennarina Arabia
- Institute of Neurology, University "Magna Graecia", Catanzaro, Italy
| | - Giuseppe Cascini
- Department of Nuclear Medicine, University "Magna Graecia", Catanzaro, Italy
| | - Aldo Quattrone
- Neuroscience Research Center, University "Magna Graecia", Catanzaro, Italy.,Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Catanzaro, Italy
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Rusholt EHL, Salvesen L, Brudek T, Tesfay B, Pakkenberg B, Olesen MV. Pathological changes in the cerebellum of patients with multiple system atrophy and Parkinson's disease-a stereological study. Brain Pathol 2020; 30:576-588. [PMID: 31769073 PMCID: PMC8018044 DOI: 10.1111/bpa.12806] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 11/13/2019] [Indexed: 12/18/2022] Open
Abstract
Multiple system atrophy (MSA) and Parkinson's disease (PD) are synucleinopathies characterized by aggregation of α-synuclein in brain cells. Recent studies have shown that morphological changes in terms of cerebral nerve cell loss and increase in glia cell numbers, the degree of brain atrophy and molecular and epidemiological findings are more severe in MSA than PD. In the present study, we performed a stereological comparison of cerebellar volumes, granule and Purkinje cells in 13 patients diagnosed with MSA [8 MSA-P (striatonigral subtype) and 5 MSA-C (olivopontocerebellar subtype)], 12 PD patients, and 15 age-matched control subjects. Only brains from MSA-C patients showed a reduction in the total number of Purkinje cells (anterior lobe) whereas both MSA-P and MSA-C patients had reduced Purkinje cell volumes (perikaryons and nuclei volume). The cerebellum of both diseases showed a reduction in the white matter volume compared to controls. The number of granule cells was unaffected in both diseases. Analyses of cell type-specific mRNA expression supported our structural data. This study of the cerebellum is in line with previous findings in the cerebrum and demonstrates that the degree of morphological changes is more pronounced in MSA-C than MSA-P and PD. Further, our results support an explicit involvement of cerebellar Purkinje cells and white matter connectivity in MSA-C > MSA-P and points to the potential importance of white matter alterations in PD pathology.
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Affiliation(s)
- Elisabeth H. L. Rusholt
- Research Laboratory for Stereology and NeuroscienceDepartment of NeurologyBispebjerg‐Frederiksberg HospitalNielsine Nielsens Vej 6BDK‐2400CopenhagenDenmark
| | - Lisette Salvesen
- Research Laboratory for Stereology and NeuroscienceDepartment of NeurologyBispebjerg‐Frederiksberg HospitalNielsine Nielsens Vej 6BDK‐2400CopenhagenDenmark
| | - Tomasz Brudek
- Research Laboratory for Stereology and NeuroscienceDepartment of NeurologyBispebjerg‐Frederiksberg HospitalNielsine Nielsens Vej 6BDK‐2400CopenhagenDenmark
| | - Betel Tesfay
- Research Laboratory for Stereology and NeuroscienceDepartment of NeurologyBispebjerg‐Frederiksberg HospitalNielsine Nielsens Vej 6BDK‐2400CopenhagenDenmark
| | - Bente Pakkenberg
- Research Laboratory for Stereology and NeuroscienceDepartment of NeurologyBispebjerg‐Frederiksberg HospitalNielsine Nielsens Vej 6BDK‐2400CopenhagenDenmark
- Institute of Clinical MedicineFaculty of Health and Medical SciencesUniversity of CopenhagenBlegdamsvej 3DK‐2200CopenhagenDenmark
| | - Mikkel V. Olesen
- Research Laboratory for Stereology and NeuroscienceDepartment of NeurologyBispebjerg‐Frederiksberg HospitalNielsine Nielsens Vej 6BDK‐2400CopenhagenDenmark
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29
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Arribarat G, Péran P. Quantitative MRI markers in Parkinson's disease and parkinsonian syndromes. Curr Opin Neurol 2020; 33:222-229. [DOI: 10.1097/wco.0000000000000796] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Chen Y, Zhu G, Liu D, Liu Y, Yuan T, Zhang X, Jiang Y, Du T, Zhang J. The morphology of thalamic subnuclei in Parkinson's disease and the effects of machine learning on disease diagnosis and clinical evaluation. J Neurol Sci 2020; 411:116721. [DOI: 10.1016/j.jns.2020.116721] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 01/23/2020] [Accepted: 02/01/2020] [Indexed: 12/16/2022]
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31
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Quattrone A, Morelli M, Quattrone A, Vescio B, Nigro S, Arabia G, Nisticò R, Novellino F, Salsone M, Arcuri P, Luca A, Mazzuca A, Alessio C, Rocca F, Caracciolo M. Magnetic Resonance Parkinsonism Index for evaluating disease progression rate in progressive supranuclear palsy: A longitudinal 2-year study. Parkinsonism Relat Disord 2020; 72:1-6. [DOI: 10.1016/j.parkreldis.2020.01.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 01/14/2020] [Accepted: 01/31/2020] [Indexed: 12/27/2022]
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Cui X, Li L, Yu L, Xing H, Chang H, Zhao L, Qian J, Song Q, Zhou S, Dong C. Gray Matter Atrophy in Parkinson's Disease and the Parkinsonian Variant of Multiple System Atrophy: A Combined ROI- and Voxel-Based Morphometric Study. Clinics (Sao Paulo) 2020; 75:e1505. [PMID: 32555945 PMCID: PMC7279630 DOI: 10.6061/clinics/2020/e1505] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 03/20/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Parkinson's disease (PD) and the parkinsonian variant of multiple system atrophy (MSA-P) are distinct neurodegenerative disorders that share similar clinical features of parkinsonism. The morphological alterations of these diseases have yet to be understood. The purpose of this study was to evaluate gray matter atrophy in PD and MSA-P using regions of interest (ROI)-based measurements and voxel-based morphometry (VBM). METHODS We studied 41 patients with PD, 20 patients with MSA-P, and 39 controls matched for age, sex, and handedness using an improved T1-weighted sequence that eased gray matter segmentation. The gray matter volumes were measured using ROI and VBM. RESULTS ROI volumetric measurements showed significantly reduced bilateral putamen volumes in MSA-P patients compared with those in PD patients and controls (p<0.05), and the volumes of the bilateral caudate nucleus were significantly reduced in both MSA-P and PD patients compared with those in the controls (p<0.05). VBM analysis revealed multifocal cortical and subcortical atrophy in both MSA-P and PD patients, and the volumes of the cerebellum and temporal lobes were remarkably reduced in MSA-P patients compared with the volumes in PD patients (p<0.05). CONCLUSIONS Both PD and MSA-P are associated with gray matter atrophy, which mainly involves the bilateral putamen, caudate nucleus, cerebellum, and temporal lobes. ROI and VBM can be used to identify these morphological alterations, and VBM is more sensitive and repeatable and less time-consuming, which may have potential diagnostic value.
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Affiliation(s)
- Xiaorui Cui
- Department of Neurology, Affiliated Hospital of Xiangnan University, Chenzhou, China
| | - Lan Li
- Department of Neurology, Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Lei Yu
- Department of Neurology, Dalian Friendship Hospital, Dalian, China
| | - Huijuan Xing
- Department of Neurology, The Third People’s Hospital of Dalian, Dalian, China
| | - Hong Chang
- Department of Neurology, The Third People’s Hospital of Dalian, Dalian, China
| | - Li Zhao
- Department of Neurology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Jin Qian
- Department of Neurology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Qingwei Song
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Shiyu Zhou
- Department of Psychology, Dalian Medical University, Dalian, China
| | - Chunbo Dong
- Department of Neurology, First Affiliated Hospital of Dalian Medical University, Dalian, China
- *Corresponding author. E-mail:
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Abstract
PURPOSE OF REVIEW Being a disease with heterogeneous presentations and unclear consensus on its diagnostic criteria, it is difficult to differentiate vascular parkinsonism (VaP) from other neurodegenerative parkinsonism variants. Ongoing research on structural and functional neuroimaging targeting dopaminergic pathway provides us more insight into the pathophysiology of VaP to improve diagnostic accuracy. The aim of this article is to review how the emerging imaging modalities help the diagnostic process and treatment decision in VaP. RECENT FINDINGS Dopamine transporter imaging is a promising tool in differentiating presynaptic parkinsonism and VaP. It also predicts the levodopa responders in VaP. Advanced MRI techniques including volumetry, diffusion tensor imaging and sequences visualising substantia nigra are under development, and they are complementary to each other in detecting structural and functional changes in VaP, which is crucial to ensure the quality of future therapeutic trials for VaP. Dopamine transporter imaging is recommended to patients with suspected VaP. Multimodal MRI in VaP would be an important area to be investigated in the near future.
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Affiliation(s)
- Karen K Y Ma
- Division of Neurology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Margaret K.L. Cheung Research Centre for Management of Parkinsonism, Gerald Choa Neuroscience Centre, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Shi Lin
- Margaret K.L. Cheung Research Centre for Management of Parkinsonism, Gerald Choa Neuroscience Centre, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Imaging & Interventional Radiology, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- BrainNow Research Institute, Guangdong Province, Shenzhen, China
| | - Vincent C T Mok
- Division of Neurology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
- Margaret K.L. Cheung Research Centre for Management of Parkinsonism, Gerald Choa Neuroscience Centre, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
- BrainNow Research Institute, Guangdong Province, Shenzhen, China.
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Increased functional connectivity of thalamic subdivisions in patients with Parkinson's disease. PLoS One 2019; 14:e0222002. [PMID: 31483847 PMCID: PMC6726201 DOI: 10.1371/journal.pone.0222002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 08/20/2019] [Indexed: 01/09/2023] Open
Abstract
Parkinson’s disease (PD) affects 2–3% of the population over the age of 65 with loss of dopaminergic neurons in the substantia nigra impacting the functioning of basal ganglia-thalamocortical circuits. The precise role played by the thalamus is unknown, despite its critical role in the functioning of the cerebral cortex, and the abnormal neuronal activity of the structure in PD. Our objective was to more clearly elucidate how functional connectivity and morphology of the thalamus are impacted in PD (n = 32) compared to Controls (n = 20). To investigate functional connectivity of the thalamus we subdivided the structure into two important regions-of-interest, the first with putative connections to the motor cortices and the second with putative connections to prefrontal cortices. We then investigated potential differences in the size and shape of the thalamus in PD, and how morphology and functional connectivity relate to clinical variables. Our data demonstrate that PD is associated with increases in functional connectivity between motor subdivisions of the thalamus and the supplementary motor area, and between prefrontal thalamic subdivisions and nuclei of the basal ganglia, anterior and dorsolateral prefrontal cortices, as well as the anterior and paracingulate gyri. These results suggest that PD is associated with increased functional connectivity of subdivisions of the thalamus which may be indicative alterations to basal ganglia-thalamocortical circuitry.
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35
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Hünerli D, Emek-Savaş DD, Çavuşoğlu B, Dönmez Çolakoğlu B, Ada E, Yener GG. Mild cognitive impairment in Parkinson’s disease is associated with decreased P300 amplitude and reduced putamen volume. Clin Neurophysiol 2019; 130:1208-1217. [DOI: 10.1016/j.clinph.2019.04.314] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 03/18/2019] [Accepted: 04/22/2019] [Indexed: 12/28/2022]
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36
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Pagnozzi AM, Fripp J, Rose SE. Quantifying deep grey matter atrophy using automated segmentation approaches: A systematic review of structural MRI studies. Neuroimage 2019; 201:116018. [PMID: 31319182 DOI: 10.1016/j.neuroimage.2019.116018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 07/01/2019] [Accepted: 07/12/2019] [Indexed: 12/13/2022] Open
Abstract
The deep grey matter (DGM) nuclei of the brain play a crucial role in learning, behaviour, cognition, movement and memory. Although automated segmentation strategies can provide insight into the impact of multiple neurological conditions affecting these structures, such as Multiple Sclerosis (MS), Huntington's disease (HD), Alzheimer's disease (AD), Parkinson's disease (PD) and Cerebral Palsy (CP), there are a number of technical challenges limiting an accurate automated segmentation of the DGM. Namely, the insufficient contrast of T1 sequences to completely identify the boundaries of these structures, as well as the presence of iso-intense white matter lesions or extensive tissue loss caused by brain injury. Therefore in this systematic review, 269 eligible studies were analysed and compared to determine the optimal approaches for addressing these technical challenges. The automated approaches used among the reviewed studies fall into three broad categories, atlas-based approaches focusing on the accurate alignment of atlas priors, algorithmic approaches which utilise intensity information to a greater extent, and learning-based approaches that require an annotated training set. Studies that utilise freely available software packages such as FIRST, FreeSurfer and LesionTOADS were also eligible, and their performance compared. Overall, deep learning approaches achieved the best overall performance, however these strategies are currently hampered by the lack of large-scale annotated data. Improving model generalisability to new datasets could be achieved in future studies with data augmentation and transfer learning. Multi-atlas approaches provided the second-best performance overall, and may be utilised to construct a "silver standard" annotated training set for deep learning. To address the technical challenges, providing robustness to injury can be improved by using multiple channels, highly elastic diffeomorphic transformations such as LDDMM, and by following atlas-based approaches with an intensity driven refinement of the segmentation, which has been done with the Expectation Maximisation (EM) and level sets methods. Accounting for potential lesions should be achieved with a separate lesion segmentation approach, as in LesionTOADS. Finally, to address the issue of limited contrast, R2*, T2* and QSM sequences could be used to better highlight the DGM due to its higher iron content. Future studies could look to additionally acquire these sequences by retaining the phase information from standard structural scans, or alternatively acquiring these sequences for only a training set, allowing models to learn the "improved" segmentation from T1-sequences alone.
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Affiliation(s)
- Alex M Pagnozzi
- CSIRO Health and Biosecurity, The Australian e-Health Research Centre, Brisbane, Australia.
| | - Jurgen Fripp
- CSIRO Health and Biosecurity, The Australian e-Health Research Centre, Brisbane, Australia
| | - Stephen E Rose
- CSIRO Health and Biosecurity, The Australian e-Health Research Centre, Brisbane, Australia
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Xu J, Zhang M. Use of Magnetic Resonance Imaging and Artificial Intelligence in Studies of Diagnosis of Parkinson's Disease. ACS Chem Neurosci 2019; 10:2658-2667. [PMID: 31083923 DOI: 10.1021/acschemneuro.9b00207] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Parkinson's disease (PD) is a common neurodegenerative disorder. It has a delitescent onset and a slow progress. The clinical manifestations of PD in patients are highly heterogeneous. Thus, PD diagnosis process is complex and mainly depends on the professional knowledge and experience of the physician. Magnetic resonance imaging (MRI) could detect the small changes in the brain of PD patients, and quantitative analysis of brain MRI may improve the clinical diagnosis efficiency. However, due to the complexity of clinical courses in PD and the high dimensionality in multimodal MRI data, traditional mathematical analysis could not effectively extract the huge information in them. Up to now, the accuracy of PD diagnosis in large sample size is still unsatisfying. As artificial intelligence (AI) is becoming more mature, varieties of statistical models and machine learning (ML) algorithms have been used for quantitative imaging data analysis to explore a diagnostic result. This review aims to state an overview of existing research recently that used statistical ML/AI methods to perform quantitative analysis of MR image data for the study of PD diagnosis. First we review the recent research in three subareas: diagnosis, differential diagnosis, and subtyping of PD. Then we described the overall workflow from MR image to classification result. Finally, we summarized a critical assessment of the current research and provide some recommendations for likely future research developments and trends.
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Affiliation(s)
- Jingjing Xu
- Department of Radiology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 31000, China
| | - Minming Zhang
- Department of Radiology, the Second Affiliated Hospital of Zhejiang University, School of Medicine, No.88 Jiefang Road, Shangcheng District, Hangzhou 31000, China
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Nemmi F, Pavy-Le Traon A, Phillips OR, Galitzky M, Meissner WG, Rascol O, Péran P. A totally data-driven whole-brain multimodal pipeline for the discrimination of Parkinson's disease, multiple system atrophy and healthy control. NEUROIMAGE-CLINICAL 2019; 23:101858. [PMID: 31128523 PMCID: PMC6531871 DOI: 10.1016/j.nicl.2019.101858] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 04/17/2019] [Accepted: 05/11/2019] [Indexed: 01/10/2023]
Abstract
Parkinson's Disease (PD) and Multiple System Atrophy (MSA) are two parkinsonian syndromes that share many symptoms, albeit having very different prognosis. Although previous studies have proposed multimodal MRI protocols combined with multivariate analysis to discriminate between these two populations and healthy controls, studies combining all MRI indexes relevant for these disorders (i.e. grey matter volume, fractional anisotropy, mean diffusivity, iron deposition, brain activity at rest and brain connectivity) with a completely data-driven voxelwise analysis for discrimination are still lacking. In this study, we used such a complete MRI protocol and adapted a fully-data driven analysis pipeline to discriminate between these populations and a healthy controls (HC) group. The pipeline combined several feature selection and reduction steps to obtain interpretable models with a low number of discriminant features that can shed light onto the brain pathology of PD and MSA. Using this pipeline, we could discriminate between PD and HC (best accuracy = 0.78), MSA and HC (best accuracy = 0.94) and PD and MSA (best accuracy = 0.88). Moreover, we showed that indexes derived from resting-state fMRI alone could discriminate between PD and HC, while mean diffusivity in the cerebellum and the putamen alone could discriminate between MSA and HC. On the other hand, a more diverse set of indexes derived by multiple modalities was needed to discriminate between the two disorders. We showed that our pipeline was able to discriminate between distinct pathological populations while delivering sparse model that could be used to better understand the neural underpinning of the pathologies. Structuro-functional MRI can discriminate between parkinsonian syndromes Discriminant MRI modalities vary as a function of the discrimination task fMRI is crucial in discriminating between Parkinson's disease patients and controls Structural MRI discriminate between Multiple System Atrophy patients and controls
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Affiliation(s)
- F Nemmi
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France.
| | - A Pavy-Le Traon
- UMR Institut National de la Santé et de la Recherche Médicale 1048, Institut des Maladies Métaboliques et Cardiovasculaires, Toulouse, France; Department of Neurology and Institute for Neurosciences, University Hospital of Toulouse, Toulouse, France
| | - O R Phillips
- Brain Key, Palo Alto, California, USA; NeuroToul COEN Center, INSERM, CHU de Toulouse, Université de Toulouse 3, Toulouse, France
| | - M Galitzky
- Centre d'Investigation Clinique (CIC), CHU de Toulouse, Toulouse, France
| | - W G Meissner
- French Reference Center for MSA, Department of Neurology, University Hospital Bordeaux, Bordeaux and Institute of Neurodegenerative Disorders, University Bordeaux, CNRS UMR 5293, 33000 Bordeaux, France; Dept. Medicine, University of Otago, Christchurch, and New Zealand Brain Research Institute, Christchurch, New Zealand
| | - O Rascol
- Departments of Clinical Pharmacology and Neurosciences, Clinical Investigation Center CIC 1436, NS-Park/FCRIN network and NeuroToul COEN Center, INSERM, CHU de Toulouse, Université de Toulouse 3, Toulouse, France
| | - P Péran
- ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, France
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Kocaman H, Acer N, Köseoğlu E, Gültekin M, Dönmez H. Evaluation of intracerebral ventricles volume of patients with Parkinson's disease using the atlas-based method: A methodological study. J Chem Neuroanat 2019; 98:124-130. [PMID: 30986488 DOI: 10.1016/j.jchemneu.2019.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 04/02/2019] [Accepted: 04/11/2019] [Indexed: 10/27/2022]
Abstract
Knowing the volumetric changes in brain can allow for the estimation of the disease progression of various neurodegenerative disorders. Many studies have been shown that the volumetric changes in the some brain structures especially including the dopaminergic neurons, in patients with Parkinson's disease (PD). The objective of this study was to compare intracerebral ventricles volume in patients with PD and healthy subjects to compare an automated atlas-based method (MRIStudio software) and a manual method (ImageJ). T1-weighted brain Magnetic Resonance Imaging (MRI) data of 21 patients with PD and 20 healthy individuals were used to calculate the intracerebral ventricle volumes. Measurement results obtained by ImageJ were considered as the gold standard. We found a significant increase in the left occipital part of the lateral ventricle volume in the patients with PD compared to the control subjects (p < 0.05). Also, no significant difference was found between the two methods of measurement (p > 0.05), meaning that a substantial agreement was found between the results obtained with the atlas-based analysis and manual method. The present study showed that MRIStudio can be performed easily and accurately on routine MRI scans for which the total intracerebral ventricles volume is to be estimated in PD. We suggest that, the attained volume values of intracerebral ventricles may provide a precious data for volumetric dependences of the anatomical structures in several clinical conditions.
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Affiliation(s)
- Hikmet Kocaman
- Karamanoğlu Mehmetbey University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Karaman 70200, Turkey.
| | - Niyazi Acer
- Erciyes University, Medical Faculty, Department of Anatomy, Kayseri 38039, Turkey
| | - Emel Köseoğlu
- Erciyes University, Medical Faculty, Department of Neurology, Kayseri 38039, Turkey
| | - Murat Gültekin
- Erciyes University, Medical Faculty, Department of Neurology, Kayseri 38039, Turkey
| | - Halil Dönmez
- Erciyes University, Medical Faculty, Department of Radiology, Kayseri 38039, Turkey
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Krismer F, Seppi K, Göbel G, Steiger R, Zucal I, Boesch S, Gizewski ER, Wenning GK, Poewe W, Scherfler C. Morphometric MRI profiles of multiple system atrophy variants and implications for differential diagnosis. Mov Disord 2019; 34:1041-1048. [PMID: 30919495 PMCID: PMC6767501 DOI: 10.1002/mds.27669] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 02/07/2019] [Accepted: 02/12/2019] [Indexed: 12/14/2022] Open
Abstract
Background Manual width measurements of the middle cerebellar peduncle on MRI were shown to improve the accuracy of an imaging‐guided diagnosis of multiple system atrophy (MSA). Recently, automated volume segmentation algorithms were able to reliably differentiate patients with Parkinson's disease (PD) and the parkinsonian variant of MSA. The objective of the current study was to integrate probabilistic information of the middle cerebellar peduncle into an existing MRI atlas for automated subcortical segmentation and to evaluate the diagnostic properties of the novel atlas for the differential diagnosis of MSA (parkinsonian and cerebellar variant) versus PD. Methods Three Tesla MRI scans of 48 healthy individuals were used to establish an automated whole‐brain segmentation procedure that includes the volumes of the putamen, cerebellar gray and white matter, and the middle cerebellar peduncles. Classification accuracy of segmented volumes were tested in early‐stage MSA patients (18 MSA‐parkinsonism, 13 MSA‐cerebellar) and 19 PD patients using a C4.5 classifier. Results Putaminal and infratentorial atrophy were present in 77.8% and 61.1% of MSA‐parkinsonian patients, respectively. Four of 18 MSA‐parkinsonian patients (22.2%) had infratentorial atrophy without evidence of putaminal atrophy. Infratentorial atrophy was present in all MSA‐cerebellar patients, with concomitant putaminal atrophy in 46.2% of these cases. The diagnostic algorithm using putaminal and infratentorial volumetric information correctly classified all PD patients and 96.8% of MSA patients. Conclusions The middle cerebellar peduncle was successfully integrated into a subcortical segmentation atlas, and its excellent diagnostic accuracy outperformed existing volumetric MRI processing strategies in differentiating MSA patients with variable atrophy patterns from PD patients. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Florian Krismer
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria.,Neuroimaging Research Core Facility, Medical University Innsbruck, Innsbruck, Austria
| | - Klaus Seppi
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria.,Neuroimaging Research Core Facility, Medical University Innsbruck, Innsbruck, Austria
| | - Georg Göbel
- Medical Statistics, Informatics and Health Economics, Medical University Innsbruck, Innsbruck, Austria
| | - Ruth Steiger
- Neuroimaging Research Core Facility, Medical University Innsbruck, Innsbruck, Austria.,Department of Neuroradiology, Medical University Innsbruck, Innsbruck, Austria
| | - Isabel Zucal
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Sylvia Boesch
- Department of Neurology, 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
| | - Gregor K Wenning
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Werner Poewe
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria.,Neuroimaging Research Core Facility, Medical University Innsbruck, Innsbruck, Austria
| | - Christoph Scherfler
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria.,Neuroimaging Research Core Facility, Medical University Innsbruck, Innsbruck, Austria
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Zou L, Song Y, Zhou X, Chu J, Tang X. Regional morphometric abnormalities and clinical relevance in Wilson's disease. Mov Disord 2019; 34:545-554. [PMID: 30817852 DOI: 10.1002/mds.27641] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 12/17/2018] [Accepted: 01/04/2019] [Indexed: 11/08/2022] Open
Affiliation(s)
- Lin Zou
- Department of Electrical and Electronic Engineering; Southern University of Science and Technology; Shenzhen Guangdong China
| | - Yukun Song
- Department of Radiology; The First Affiliated Hospital of Xiamen University; Xiamen Fujian China
| | - Xiangxue Zhou
- Department of Neurology, Eastern Hospital; The First Affiliated Hospital of Sun Yat-sen University; Guangzhou Guangdong China
| | - Jianping Chu
- Department of Radiology; The First Affiliated Hospital of Sun Yat-sen University; Guangzhou Guangdong China
| | - Xiaoying Tang
- Department of Electrical and Electronic Engineering; Southern University of Science and Technology; Shenzhen Guangdong China
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Do multiple system atrophy and Parkinson's disease show distinct patterns of volumetric alterations across hippocampal subfields? An exploratory study. Eur Radiol 2019; 29:4948-4956. [PMID: 30796577 DOI: 10.1007/s00330-019-06043-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 12/25/2018] [Accepted: 01/24/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To investigate the volumetric alterations of hippocampal subfields and identify which subfields contribute to mild cognitive impairment (MCI) in multiple system atrophy (MSA) and Parkinson's disease (PD). METHODS Thirty MSA-MCI, 26 PD-MCI, and 30 healthy controls were administered cognitive assessment, along with hippocampal segmentation using FreeSurfer 6.0 after a 3-T MRI scan. Regression analyses were performed between the volumes of hippocampal subfields and cognitive variables. RESULTS Compared with healthy controls, the volume of the hippocampal fissure was enlarged in PD-MCI patients, while left Cornu Ammonis (CA2-CA3), bilateral molecular layer, bilateral hippocampus-amygdala transition area, right subiculum, right CA1, right presubiculum, right parasubiculum, and bilateral whole hippocampus were reduced in the MSA-MCI group. Moreover, volumetric reductions of the bilateral hippocampal tail, bilateral CA1, bilateral presubiculum, bilateral molecular layer, left CA2-CA3, left hippocampus-amygdala transition area, right parasubiculum, and bilateral whole hippocampus were found in MSA-MCI relative to the PD-MCI group. The volumes of the left CA2-CA3 (B = - 11.34, p = 0.006) and left parasubiculum (B = 4.63, p = 0.01) were respectively correlated with language and abstraction functions. The volumes of the left fimbria (B = 6.99, p = 0.002) and left hippocampus-amygdala transition area (B = 2.28, p = 0.009) were correlated with visuospatial/executive function. CONCLUSIONS The MSA-MCI patients showed more widespread impairment of hippocampal subfields compared with the PD-MCI group, involving trisynaptic loop and amygdala-hippocampus interactions. The alteration of CA, hippocampus-amygdala transition area, and fimbria still requires further comparison between the two patient groups. KEY POINTS • The atrophy patterns of hippocampal subfields differed between MSA and PD patients. • MSA has widespread change in trisynaptic loop and amygdala-hippocampus interactions. • The atrophy patterns may help to understand the differences of cognitive impairment in MSA and PD.
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Quattrone A, Morelli M, Vescio B, Nigro S, Le Piane E, Sabatini U, Caracciolo M, Vescio V, Quattrone A, Barbagallo G, Stanà C, Nicoletti G, Arabia G, Nisticò R, Novellino F, Salsone M. Refining initial diagnosis of Parkinson's disease after follow-up: A 4-year prospective clinical and magnetic resonance imaging study. Mov Disord 2019; 34:487-495. [PMID: 30759325 PMCID: PMC6593994 DOI: 10.1002/mds.27621] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 12/27/2018] [Accepted: 01/02/2019] [Indexed: 01/05/2023] Open
Abstract
Background No prospective study of patients with Parkinson's disease (PD) has investigated the appearance of vertical gaze abnormalities, a feature suggestive of progressive supranuclear palsy (PSP). Objective To identify, within a cohort of patients with an initial diagnosis of PD, those who developed vertical gaze abnormalities during a 4‐year follow‐up, and to investigate the performance of new imaging biomarkers in predicting vertical gaze abnormalities. Methods A total of 110 patients initially classified as PD and 74 controls were enrolled. All patients underwent clinical assessment at baseline and every year up to the end of the follow‐up. The pons/midbrain area ratio 2.0 and the Magnetic Resonance Parkinsonism Index 2.0 were calculated. Results After 4‐year follow‐up, 100 of 110 patients maintained the diagnosis of PD, whereas 10 PD patients (9.1%) developed vertical gaze abnormalities, suggesting an alternative diagnosis of PSP‐parkinsonism. At baseline, the Magnetic Resonance Parkinsonism Index 2.0 was the most accurate biomarker in differentiating PD patients who developed vertical gaze abnormalities from those who maintained an initial diagnosis of PD. At the end of follow‐up, both of these biomarkers accurately distinguished PSP‐parkinsonism from PD. Conclusions Our results demonstrate that a number of patients with an initial diagnosis of PD developed vertical gaze abnormalities during a 4‐year follow‐up, and the diagnosis was changed from PD to PSP‐parkinsonism. In PD patients, baseline Magnetic Resonance Parkinsonism Index 2.0 showed the best performance in predicting the clinical evolution toward a PSP‐parkinsonism phenotype, enabling PSP‐parkinsonism patients to be identified at the earliest stage of the disease for promising disease‐modifying therapies. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Aldo Quattrone
- Neuroscience Centre, Magna Graecia University, Catanzaro, Italy.,Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Maurizio Morelli
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy.,Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | | | - Salvatore Nigro
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Emilio Le Piane
- Department of Neurology, Pugliese-Ciaccio Hospital, Catanzaro, Italy
| | - Umberto Sabatini
- Institute of Neuroradiology, Magna Graecia University, Catanzaro, Italy
| | - Manuela Caracciolo
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Virginia Vescio
- Institute of Neuroradiology, Magna Graecia University, Catanzaro, Italy
| | - Andrea Quattrone
- Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Gaetano Barbagallo
- Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Carlo Stanà
- Institute of Neuroradiology, Magna Graecia University, Catanzaro, Italy
| | - Giuseppe Nicoletti
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Gennarina Arabia
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy.,Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy
| | - Rita Nisticò
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Fabiana Novellino
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
| | - Maria Salsone
- Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy
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Wang N, Zhang L, Yang H, Liu H, Luo X, Fan G. Similarities and differences in cerebellar grey matter volume and disrupted functional connectivity in idiopathic Parkinson's disease and multiple system atrophy. Neuropsychologia 2019; 124:125-132. [DOI: 10.1016/j.neuropsychologia.2018.12.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 10/13/2018] [Accepted: 12/21/2018] [Indexed: 01/02/2023]
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Zhang L, Zhang L, Xue F, Yue K, Peng H, Wu Y, Sha O, Yang L, Ding Y. Brain morphological alteration and cognitive dysfunction in multiple system atrophy. Quant Imaging Med Surg 2018; 8:1030-1038. [PMID: 30598880 DOI: 10.21037/qims.2018.11.02] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Multiple system atrophy (MSA) is a progressive neurodegenerative disease in adults, manifesting various clinical symptoms including autonomic nerve dysfunction, Parkinson's syndrome, cerebellar ataxia, and pyramidal sign. The clinical diagnosis and classification of MSA are mainly dependent on motion and non-motion symptoms, such as autonomic nerve dysfunction. In addition, an increasing amount of clinical and pathological evidence has shown that about half of the MSA patients exhibit distinct types and levels of cognitive dysfunction. However, cognitive dysfunction has not been included in the current diagnosis criteria of MSA. In most cases, it was even used as an exclusion criterion of MSA. Based on the neuroimaging, neuropathology and neuropsychology, this review summarized the morphological changes of the brain in the patients with MSA, and discussed possible brain regions that could be associated with cognitive impairment. The article may provide a theoretical basis for incorporating cognitive dysfunction into the criteria of MSA diagnosis.
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Affiliation(s)
- Lihong Zhang
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - Li Zhang
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
| | - Fang Xue
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - Kathy Yue
- School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA
| | - Haixin Peng
- Department of Food Science and Nutrition, Sichuan Agricultural University, Chengdu 611130, China
| | - Ya'nan Wu
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - Ou Sha
- Department of Anatomy, Histology and Developmental Biology, School of Basic Medical Sciences, Shenzhen University Health Science Centre, Shenzhen 518060, China
| | - Lan Yang
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
| | - Yan Ding
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
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Talai AS, Sedlacik J, Boelmans K, Forkert ND. Widespread diffusion changes differentiate Parkinson's disease and progressive supranuclear palsy. NEUROIMAGE-CLINICAL 2018; 20:1037-1043. [PMID: 30342392 PMCID: PMC6197764 DOI: 10.1016/j.nicl.2018.09.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 07/17/2018] [Accepted: 09/25/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Parkinson's disease (PD) and progressive supranuclear palsy - Richardson's syndrome (PSP-RS) are often represented by similar clinical symptoms, which may challenge diagnostic accuracy. The objective of this study was to investigate and compare regional cerebral diffusion properties in PD and PSP-RS subjects and evaluate the use of these metrics for an automatic classification framework. MATERIAL AND METHODS Diffusion-tensor MRI datasets from 52 PD and 21 PSP-RS subjects were employed for this study. Using an atlas-based approach, regional median values of mean diffusivity (MD), fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD) were measured and employed for feature selection using RELIEFF and subsequent classification using a support vector machine. RESULTS According to RELIEFF, the top 17 diffusion values consisting of deep gray matter structures, the brainstem, and frontal cortex were found to be especially informative for an automatic classification. A MANCOVA analysis performed on these diffusion values as dependent variables revealed that PSP-RS and PD subjects differ significantly (p < .001). Generally, PSP-RS subjects exhibit reduced FA, and increased MD, RD, and AD values in nearly all brain structures analyzed compared to PD subjects. The leave-one-out cross-validation of the support vector machine classifier revealed that the classifier can differentiate PD and PSP-RS subjects with an accuracy of 87.7%. More precisely, six PD subjects were wrongly classified as PSP-RS and three PSP-RS subjects were wrongly classified as PD. CONCLUSION The results of this study demonstrate that PSP-RS subjects exhibit widespread and more severe diffusion alterations compared to PD patients, which appears valuable for an automatic computer-aided diagnosis approach.
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Affiliation(s)
- Aron S Talai
- Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Canada
| | - Jan Sedlacik
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Germany
| | - Kai Boelmans
- Department of Neurology, University Hospital Würzburg, Germany
| | - Nils D Forkert
- Department of Radiology, Hotchkiss Brain Institute, University of Calgary, Canada.
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Abstract
Qualitative and quantitative structural magnetic resonance imaging offer objective measures of the underlying neurodegeneration in atypical parkinsonism. Regional changes in tissue volume, signal changes and increased deposition of iron as assessed with different structural MRI techniques are surrogate markers of underlying neurodegeneration and may reflect cell loss, microglial proliferation and astroglial activation. Structural MRI has been explored as a tool to enhance diagnostic accuracy in differentiating atypical parkinsonian disorders (APDs). Moreover, the longitudinal assessment of serial structural MRI-derived parameters offers the opportunity for robust inferences regarding the progression of APDs. This review summarizes recent research findings as (1) a diagnostic tool for APDs as well as (2) as a tool to assess longitudinal changes of serial MRI-derived parameters in the different APDs.
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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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Talai AS, Ismail Z, Sedlacik J, Boelmans K, Forkert ND. Improved Automatic Morphology-Based Classification of Parkinson's Disease and Progressive Supranuclear Palsy. Clin Neuroradiol 2018; 29:605-614. [PMID: 30218110 DOI: 10.1007/s00062-018-0727-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 08/25/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The overlapping symptoms of Parkinson's disease (PD) and progressive supranuclear palsy-Richardson's syndrome (PSP-RS) often make a correct clinical diagnosis difficult. The volume of subcortical brain structures derived from high-resolution T1-weighted magnetic resonance imaging (MRI) datasets is frequently used for individual level classification of PD and PSP-RS patients. The aim of this study was to evaluate the benefit of including additional morphological features beyond the simple regional volume, as well as clinical features, and morphological features of cortical structures for an automatic classification of PD and PSP-RS patients. MATERIAL AND METHODS A total of 98 high-resolution T1-weighted MRI datasets from 76 PD patients, and 22 PSP-RS patients were available for this study. Using an atlas-based approach, the volume, surface area, and surface-area-to-volume ratio (SA:V) of 21 subcortical and 48 cortical brain regions were calculated and used as features for a support vector machine classification after application of a RELIEF feature selection method. RESULTS The comparison of the classification results suggests that including all three morphological parameters (volume, surface area and SA:V) can considerably improve classification accuracy compared to using volume or surface area alone. Likewise, including clinical patient features in addition to morphological parameters also considerably increases the classification accuracy. In contrast to this, integrating morphological features of other cortical structures did not lead to improved classification accuracy. Using this optimal set-up, an accuracy of 98% was achieved with only one falsely classified PD and one falsely classified PSP-RS patient. CONCLUSION The results of this study suggest that clinical features as well as more advanced morphological features should be used for future computer-aided diagnosis systems to differentiate PD and PSP-RS patients based on morphological parameters.
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Affiliation(s)
- Aron S Talai
- Department of Radiology and Hotchkiss Brain Institute, Faculty of Medicine, University of Calgary, 3330 Hospital Drive NW, AB T2N 4N1, Calgary, Canada
| | - Zahinoor Ismail
- Departments of Psychiatry, Clinical Neurosciences, and Community Health Sciences, and Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Jan Sedlacik
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kai Boelmans
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Nils D Forkert
- Department of Radiology and Hotchkiss Brain Institute, Faculty of Medicine, University of Calgary, 3330 Hospital Drive NW, AB T2N 4N1, Calgary, Canada.
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Comparative cognitive and neuropsychiatric profiles between Parkinson’s disease, multiple system atrophy and progressive supranuclear palsy. J Neurol 2018; 265:2602-2613. [DOI: 10.1007/s00415-018-9038-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 08/25/2018] [Accepted: 08/27/2018] [Indexed: 01/18/2023]
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