Jérémy Deverdun1, Sophie Menjot de Champfleur2, Simon Cabello-Aguilar3, Florence Maury4, François Molino5, Mahmoud Charif4, Nicolas Leboucq6, Xavier Ayrignac4, Pierre Labauge4, Alain Bonafe7, Giovanni Castelnovo8, Emmanuelle Le Bars3, Christian Geny9, Nicolas Menjot de Champfleur10. 1. Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier, France; Laboratoire Charles Coulomb, CNRS UMR 5221 - Université Montpellier II, Montpellier, France; I2FH, Institut d'Imagerie Fonctionnelle Humaine, Hôpital Gui de Chauliac, CHRU de, Montpellier, France. 2. Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier, France; Clinique du Parc, Castelnau-le-Lez, France. 3. Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier, France; I2FH, Institut d'Imagerie Fonctionnelle Humaine, Hôpital Gui de Chauliac, CHRU de, Montpellier, France. 4. Department of Neurology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier, France. 5. Laboratoire Charles Coulomb, CNRS UMR 5221 - Université Montpellier II, Montpellier, France; Institut de Génomique Fonctionnelle, UMR 5203 - INSERM U661 - Université Montpellier II - Université, Montpellier I, France. 6. Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier, France. 7. Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier, France; I2FH, Institut d'Imagerie Fonctionnelle Humaine, Hôpital Gui de Chauliac, CHRU de, Montpellier, France; Team "Plasticity of Central Nervous System, Stem Cells and Glial Tumors", U1051, Institut of Neurosciences of Montpellier, Saint Eloi Hospital, Montpellier, France. 8. Department of Neurology, Caremeau University Hospital Center, Nîmes, France. 9. Department of Neurology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier, France; EuroMov, 700 Avenue du Pic Saint Loup - 34090, Montpellier, France; Movement to Health (M2H), Montpellier-1 University, France. 10. Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier, France; I2FH, Institut d'Imagerie Fonctionnelle Humaine, Hôpital Gui de Chauliac, CHRU de, Montpellier, France; Institut de Génomique Fonctionnelle, UMR 5203 - INSERM U661 - Université Montpellier II - Université, Montpellier I, France. Electronic address: nicolasdechampfleur@orange.fr.
Abstract
BACKGROUND AND PURPOSE: The etiologic diagnosis of parkinsonian syndromes is of particular importance when considering syndromes of vascular or degenerative origin. The purpose of this study is to find differences in the white-matter architecture between those two groups in elderly patients. MATERIALS AND METHODS: Thirty-five patients were prospectively included (multiple-system atrophy, n=5; Parkinson's disease, n=15; progressive supranuclear palsy, n=9; vascular parkinsonism, n=6), with a mean age of 76 years. Patients with multiple-system atrophy, progressive supranuclear palsy and Parkinson's disease were grouped as having parkinsonian syndromes of degenerative origin. Brain MRIs included diffusion tensor imaging. Fractional anisotropy and mean-diffusivity maps were spatially normalized, and group analyses between parkinsonian syndromes of degenerative origin and vascular parkinsonism were performed using a voxel-based approach. RESULTS: Statistical parametric-mapping analysis of diffusion tensor imaging data showed decreased fractional anisotropy value in internal capsules bilaterally in patients with vascular parkinsonism compared to parkinsonian syndromes of degenerative origin (p=0.001) and showed a lower mean diffusivity in the white matter of the left superior parietal lobule (p=0.01). Fractional anisotropy values were found decreased in the middle cerebellar peduncles in multiple-system atrophy compared to Parkinson's disease and progressive supranuclear palsy. The mean diffusivity was increased in those regions for these subgroups. CONCLUSION: Clinically defined vascular parkinsonism was associated with decreased fractional anisotropy in the deep white matter (internal capsules) compared to parkinsonian syndromes of degenerative origin. These findings are consistent with previously published neuropathological data.
BACKGROUND AND PURPOSE: The etiologic diagnosis of parkinsonian syndromes is of particular importance when considering syndromes of vascular or degenerative origin. The purpose of this study is to find differences in the white-matter architecture between those two groups in elderly patients. MATERIALS AND METHODS: Thirty-five patients were prospectively included (multiple-system atrophy, n=5; Parkinson's disease, n=15; progressive supranuclear palsy, n=9; vascular parkinsonism, n=6), with a mean age of 76 years. Patients with multiple-system atrophy, progressive supranuclear palsy and Parkinson's disease were grouped as having parkinsonian syndromes of degenerative origin. Brain MRIs included diffusion tensor imaging. Fractional anisotropy and mean-diffusivity maps were spatially normalized, and group analyses between parkinsonian syndromes of degenerative origin and vascular parkinsonism were performed using a voxel-based approach. RESULTS: Statistical parametric-mapping analysis of diffusion tensor imaging data showed decreased fractional anisotropy value in internal capsules bilaterally in patients with vascular parkinsonism compared to parkinsonian syndromes of degenerative origin (p=0.001) and showed a lower mean diffusivity in the white matter of the left superior parietal lobule (p=0.01). Fractional anisotropy values were found decreased in the middle cerebellar peduncles in multiple-system atrophy compared to Parkinson's disease and progressive supranuclear palsy. The mean diffusivity was increased in those regions for these subgroups. CONCLUSION: Clinically defined vascular parkinsonism was associated with decreased fractional anisotropy in the deep white matter (internal capsules) compared to parkinsonian syndromes of degenerative origin. These findings are consistent with previously published neuropathological data.
Authors: Helena M van der Holst; Inge W M van Uden; Anil M Tuladhar; Karlijn F de Laat; Anouk G W van Norden; David G Norris; Ewoud J van Dijk; Rianne A J Esselink; Bram Platel; Frank-Erik de Leeuw Journal: Neurology Date: 2015-10-07 Impact factor: 9.910
Authors: Frederick J A Meijer; Anouke van Rumund; Anil M Tuladhar; Marjolein B Aerts; Imke Titulaer; Rianne A J Esselink; Bastiaan R Bloem; Marcel M Verbeek; Bozena Goraj Journal: Neuroradiology Date: 2015-04-07 Impact factor: 2.804