TY - JOUR
T1 - Diagnostic Potential of Multimodal MRI Markers in Atypical Parkinsonian Disorders
AU - Seki, Morinobu
AU - Seppi, Klaus
AU - Mueller, Christoph
AU - Potrusil, Thomas
AU - Goebel, Georg
AU - Reiter, Eva
AU - Nocker, Michael
AU - Kremser, Christian
AU - Wildauer, Matthias
AU - Schocke, Michael
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 num- The supplementary material is available in the electronic version of this article: http://dx.doi.org/ 10.3233/JPD-181568.
Publisher Copyright:
© 2019 - IOS Press and the authors. All rights reserved.
PY - 2019
Y1 - 2019
N2 - The diagnostic potential of multimodal MRI approaches to discriminate among progressive supranuclear palsy (PSP), Parkinson variant of multiple system atrophy (MSA-P) and Parkinson's disease (PD) has not been well investigated. Objective: To identify disease-specific neurodegenerative patterns and evaluate the diagnostic accuracy of dedicated MRI, iron concentration (R2), microstructural integrity (mean diffusivity; MD and fractional anisotropy; FA) as well as volumes were analyzed in patients with PSP, MSA-P and PD. Methods: 3T MRI of 18 PSP and 16 MSA-P patients were compared with 16 PD patients matched for age and disease duration as well as 21 healthy controls. Statistical parametric mapping (SPM) was applied to objectively identify focal MRI changes throughout the whole-brain. Following dimensionality reduction of significant and multiple comparison-corrected SPM clusters through principal component analysis (PCA), stepwise receiver-operating characteristic curve analysis (ROC) was applied to determine the diagnostic potential of multimodal MRI parameters. Results: PCA revealed two components involving multiple regions identified from SPM analysis. The first component was primarily composed of the mean MD value of the thalamus and the mean MD and FA values of the dentatorubrothalamic tract and the corpus callosum. The second component mainly consisted of mean MD and FA values of the middle cerebellar peduncle. ROC analysis showed 92% of PSP patients were differentiated correctly from MSA-P and PD and 80% of MSA-P patients could be distinguished from PD. Conclusion: Multimodal MRI improved the detection of disease-specific neurodegenerative patterns in PSP and MSA-P and highlights its potential to improve the diagnostic accuracy of atypical parkinsonian disorders.
AB - The diagnostic potential of multimodal MRI approaches to discriminate among progressive supranuclear palsy (PSP), Parkinson variant of multiple system atrophy (MSA-P) and Parkinson's disease (PD) has not been well investigated. Objective: To identify disease-specific neurodegenerative patterns and evaluate the diagnostic accuracy of dedicated MRI, iron concentration (R2), microstructural integrity (mean diffusivity; MD and fractional anisotropy; FA) as well as volumes were analyzed in patients with PSP, MSA-P and PD. Methods: 3T MRI of 18 PSP and 16 MSA-P patients were compared with 16 PD patients matched for age and disease duration as well as 21 healthy controls. Statistical parametric mapping (SPM) was applied to objectively identify focal MRI changes throughout the whole-brain. Following dimensionality reduction of significant and multiple comparison-corrected SPM clusters through principal component analysis (PCA), stepwise receiver-operating characteristic curve analysis (ROC) was applied to determine the diagnostic potential of multimodal MRI parameters. Results: PCA revealed two components involving multiple regions identified from SPM analysis. The first component was primarily composed of the mean MD value of the thalamus and the mean MD and FA values of the dentatorubrothalamic tract and the corpus callosum. The second component mainly consisted of mean MD and FA values of the middle cerebellar peduncle. ROC analysis showed 92% of PSP patients were differentiated correctly from MSA-P and PD and 80% of MSA-P patients could be distinguished from PD. Conclusion: Multimodal MRI improved the detection of disease-specific neurodegenerative patterns in PSP and MSA-P and highlights its potential to improve the diagnostic accuracy of atypical parkinsonian disorders.
KW - Multimodal MRI
KW - R2
KW - diffusion tensor imaging
KW - multiple system atrophy
KW - principal component analysis
KW - progressive supranuclear palsy
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U2 - 10.3233/JPD-181568
DO - 10.3233/JPD-181568
M3 - Article
C2 - 31450511
AN - SCOPUS:85073184066
SN - 1877-7171
VL - 9
SP - 681
EP - 691
JO - Journal of Parkinson's Disease
JF - Journal of Parkinson's Disease
IS - 4
ER -