TY - JOUR
T1 - Diagnostic potential of dentatorubrothalamic tract analysis in progressive supranuclear palsy
AU - Seki, Morinobu
AU - Seppi, Klaus
AU - Mueller, Christoph
AU - Potrusil, Thomas
AU - Goebel, Georg
AU - Reiter, Eva
AU - Nocker, Michael
AU - Steiger, Ruth
AU - Wildauer, Matthias
AU - Gizewski, Elke R.
AU - Wenning, Gregor K.
AU - Poewe, Werner
AU - Scherfler, Christoph
N1 - Funding Information:
This study was funded by the Oesterreichische Nationalbank (Austrian Central Bank, Anniversary Fund, project number: 14174 ), the Austrian Science Fund (FWF: Der Wissenschaftsfonds, project number: KLI82-B00 ), the Uehara Memorial Foundation and Grants for International Activities in Life Sciences and Medicine, Keio University Medical Science Fund .
Publisher Copyright:
© 2018 Elsevier Ltd
PY - 2018/4
Y1 - 2018/4
N2 - Background: The differentiation of progressive supranuclear palsy-parkinsonism (PSP-P) from Parkinson's disease (PD) remains a major clinical challenge. Objectives: To evaluate the diagnostic potential of observer-independent assessments of microstructural integrity within infratentorial brain regions to differentiate PSP-Richardson's syndrome (PSP-RS), PSP-P and PD. Methods: 3T MRI parameters of mean diffusivity, fractional anisotropy, grey and white matter volumes from patients with PSP-RS (n = 12), PSP-P (n = 12) and mean disease duration of 2.4 ± 1.7 years were compared with PD patients (n = 20) and healthy controls (n = 23) by using statistical parametric mapping and the spatially unbiased infratentorial template. Subsequently MRI measurements of the dentatorubrothalamic tract were determined observer-independently by a validated probabilistic infratentorial atlas. The impairment of gait and postural stability was evaluated by a sum-score derived from the Unified Parkinson Disease Rating Scale. Results: Significant mean diffusivity increases, fractional anisotropy decreases and corresponding volume loss were localized in mesencephalic tegmentum, superior cerebellar peduncle, decussation of superior cerebellar peduncle and dentate nucleus in PSP-RS and PSP-P compared to PD and healthy controls. Altered microstructural integrity of the dentatorubrothalamic tract in PSP-RS was significantly more pronounced compared to PSP-P and correlated significantly with the gait and postural stability sum-score. Linear discriminant analysis identified diffusion tensor imaging measures of the dentatorubrothalamic tract and the gait and postural stability sum-score to classify correctly 95.5% of PRP-RS, PSP-P and PD patients. Conclusions: Observer-independent analysis of microstructural integrity within the dentatorubrothalamic tract in combination with assessments of gait and postural stability differentiate PSP-P from PSP-RS and PD in early to moderately advanced stages.
AB - Background: The differentiation of progressive supranuclear palsy-parkinsonism (PSP-P) from Parkinson's disease (PD) remains a major clinical challenge. Objectives: To evaluate the diagnostic potential of observer-independent assessments of microstructural integrity within infratentorial brain regions to differentiate PSP-Richardson's syndrome (PSP-RS), PSP-P and PD. Methods: 3T MRI parameters of mean diffusivity, fractional anisotropy, grey and white matter volumes from patients with PSP-RS (n = 12), PSP-P (n = 12) and mean disease duration of 2.4 ± 1.7 years were compared with PD patients (n = 20) and healthy controls (n = 23) by using statistical parametric mapping and the spatially unbiased infratentorial template. Subsequently MRI measurements of the dentatorubrothalamic tract were determined observer-independently by a validated probabilistic infratentorial atlas. The impairment of gait and postural stability was evaluated by a sum-score derived from the Unified Parkinson Disease Rating Scale. Results: Significant mean diffusivity increases, fractional anisotropy decreases and corresponding volume loss were localized in mesencephalic tegmentum, superior cerebellar peduncle, decussation of superior cerebellar peduncle and dentate nucleus in PSP-RS and PSP-P compared to PD and healthy controls. Altered microstructural integrity of the dentatorubrothalamic tract in PSP-RS was significantly more pronounced compared to PSP-P and correlated significantly with the gait and postural stability sum-score. Linear discriminant analysis identified diffusion tensor imaging measures of the dentatorubrothalamic tract and the gait and postural stability sum-score to classify correctly 95.5% of PRP-RS, PSP-P and PD patients. Conclusions: Observer-independent analysis of microstructural integrity within the dentatorubrothalamic tract in combination with assessments of gait and postural stability differentiate PSP-P from PSP-RS and PD in early to moderately advanced stages.
KW - Dentatorubrothalamic tract
KW - Diagnostic marker
KW - Diffusion tensor imaging
KW - Progressive supranuclear palsy-parkinsonism
KW - Richardson's syndrome
UR - http://www.scopus.com/inward/record.url?scp=85042080328&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85042080328&partnerID=8YFLogxK
U2 - 10.1016/j.parkreldis.2018.02.004
DO - 10.1016/j.parkreldis.2018.02.004
M3 - Article
C2 - 29463454
AN - SCOPUS:85042080328
SN - 1353-8020
VL - 49
SP - 81
EP - 87
JO - Parkinsonism and Related Disorders
JF - Parkinsonism and Related Disorders
ER -