Gaetano Barbagallo1,2,3, Maria Sierra-Peña4, Federico Nemmi5, Anne Pavy-Le Traon6, Wassilios G Meissner7,8,9,10, Olivier Rascol1,2,6,11, Patrice Péran1,2. 1. INSERM, Imagerie Cérébrale et Handicaps Neurologiques, UMR 825, 31059, Toulouse, France. 2. Université de Toulouse (UPS), Imagerie Cérébrale et Handicaps Neurologiques, Toulouse, France. 3. Institute of Neurology, University Magna Graecia, Catanzaro, Italy. 4. Service of Neurology, University Hospital "Marqués de Valdecilla (IFIMAV)," University of Cantabria and "Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED),", Santander, Spain. 5. Neuroscience Department, Retzius vag 8, Karolinska Institutet, Stockholm, Sweden. 6. Centre de Référence Atrophie Multisystématisée, Centre Hospitalier Universitaire de Toulouse, Toulouse, France. 7. Centre de Référence Atrophie Multisystématisée, Centre Hospitalier Universitaire de Bordeaux, Pessac, France. 8. Service de Neurologie, Centre Hospitalier Universitaire de Bordeaux, Pessac, France. 9. Université de Bordeaux, Institut des Maladies Neurodégénératives, Bordeaux, France. 10. CNRS, Institut des Maladies Neurodégénératives, Bordeaux, France. 11. Département de Pharmacologie Clinique, INSERM CIC1436, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
Abstract
BACKGROUND: Parkinson's disease (PD) and multiple system atrophy (MSA) are two neurodegenerative alpha-synucleinopathies characterized by severe impairment of the nigro-striatal pathway. Based on T1-, T2*-, and diffusion-weighted magnetic resonance imaging (MRI), macro-structural and micro-structural abnormalities in these diseases can be detected. OBJECTIVE: This study was undertaken to compare the nigro-striatal changes that occur in patients with PD with those in patients with both variants of MSA (the parkinsonian variant, MSA-P, and the cerebellar variant, MSA-C), and to explore correlations between different MRI parameters and clinical data. METHODS: We simultaneously measured volume, T2* relaxation rates, and mean diffusivity in nigro-striatal structures (substantia nigra, caudate nucleus, and putamen) of 26 patients with PD and 29 patients with MSA (16 with MSA-P and 13 with MSA-C). RESULTS: Significant changes in the putamina in patients with MSA were observed compared with patients with PD. Patients with MSA-P had higher mean diffusivity values in their putamina than did patients with PD or MSA-C. The putamina of both subgroups of MSA had higher T2* relaxation rates values than PD. Remarkably, discriminant analysis showed that using two measurements of microstructural damage (T2* relaxation rates and mean diffusivity in the putamen) allowed 96% accuracy to distinguish patients with PD from those with MSA-P. Correlation analyses between MRI findings and clinical variables revealed that patients with PD showed significant correlations only at the nigra. In patients with MSA, clinical variables correlated with MRI findings in both the nigra and striatum. CONCLUSIONS: Multimodal MRI reveals different pattern of nigro-striatal involvement in patients with PD and patients with MSA.
BACKGROUND:Parkinson's disease (PD) and multiple system atrophy (MSA) are two neurodegenerative alpha-synucleinopathies characterized by severe impairment of the nigro-striatal pathway. Based on T1-, T2*-, and diffusion-weighted magnetic resonance imaging (MRI), macro-structural and micro-structural abnormalities in these diseases can be detected. OBJECTIVE: This study was undertaken to compare the nigro-striatal changes that occur in patients with PD with those in patients with both variants of MSA (the parkinsonian variant, MSA-P, and the cerebellar variant, MSA-C), and to explore correlations between different MRI parameters and clinical data. METHODS: We simultaneously measured volume, T2* relaxation rates, and mean diffusivity in nigro-striatal structures (substantia nigra, caudate nucleus, and putamen) of 26 patients with PD and 29 patients with MSA (16 with MSA-P and 13 with MSA-C). RESULTS: Significant changes in the putamina in patients with MSA were observed compared with patients with PD. Patients with MSA-P had higher mean diffusivity values in their putamina than did patients with PD or MSA-C. The putamina of both subgroups of MSA had higher T2* relaxation rates values than PD. Remarkably, discriminant analysis showed that using two measurements of microstructural damage (T2* relaxation rates and mean diffusivity in the putamen) allowed 96% accuracy to distinguish patients with PD from those with MSA-P. Correlation analyses between MRI findings and clinical variables revealed that patients with PD showed significant correlations only at the nigra. In patients with MSA, clinical variables correlated with MRI findings in both the nigra and striatum. CONCLUSIONS: Multimodal MRI reveals different pattern of nigro-striatal involvement in patients with PD and patients with MSA.
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Authors: Derek B Archer; Justin T Bricker; Winston T Chu; Roxana G Burciu; Johanna L Mccracken; Song Lai; Stephen A Coombes; Ruogu Fang; Angelos Barmpoutis; Daniel M Corcos; Ajay S Kurani; Trina Mitchell; Mieniecia L Black; Ellen Herschel; Tanya Simuni; Todd B Parrish; Cynthia Comella; Tao Xie; Klaus Seppi; Nicolaas I Bohnen; Martijn L T M Müller; Roger L Albin; Florian Krismer; Guangwei Du; Mechelle M Lewis; Xuemei Huang; Hong Li; Ofer Pasternak; Nikolaus R McFarland; Michael S Okun; David E Vaillancourt Journal: Lancet Digit Health Date: 2019-08-27
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