Accuracy of nigrosome-1 detection to discriminate patients with Parkinson’s disease and essential tremor

Akly, Manuel Pérez; Stefani, Carla; Ciancaglini, L; Bestoso, Jose Santiago S.; Funes, J.; Bauso, Diego; Besada, Cristina

doi:10.1177/1971400919853787

Cited by 24 publications

(15 citation statements)

References 35 publications

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“…In the general population, the IPS to APS ratio and the PS to Non-PS ratio are very dissimilar to our study cohort. A case-control study from Perez Akly et al compared N1 evaluation results of 16 patients with IPS and 16 patients with essential tremor [25]. The sensitivity and specificity was 94% and 75-88%, respectively, which is higher than reported in our data (83% and 66%, respectively).…”

Section: Discussioncontrasting

confidence: 79%

Comparison of 6-[18F]FDOPA PET with Nigrosome 1 detection in patients with parkinsonism

et al. 2021

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Background The functional 6-[18F]FDOPA positron emission tomography (PET) can be a helpful tool in differentiating parkinsonism with dopaminergic deficiency from clinically similar differential diagnoses. Furthermore, in T2*/susceptibility-weighted imaging (SWI) magnetic resonance imaging (MRI) sequences the structural integrity of the Nigrosome 1 (N1) can be assessed by checking the presence of the swallow tail sign (STS). We therefore retrospectively compared the performance of the 6-[18F]FDOPA PET with the N1 detection in patients suspected with parkinsonian diseases. Forty-three consecutive patients (m: 23, f: 20, mean age: 63 ± 12 years) were included in the study. They underwent clinically indicated 6-[18F]FDOPA PET/MRI scans as part of their neurological evaluation of uncertain parkinsonian syndromes. Visual and semi-quantitative PET imaging results were statistically compared with visual N1 assessment on 3 T SWI. As the gold standard, we defined the clinical diagnosis at the last follow-up, which included idiopathic Parkinson syndrome (IPS; n = 18), atypical parkinsonian syndromes (APS; n = 9) and other neurological diseases without dopaminergic deficit (n = 16). Results Thirty-five of 43 patients (81%, Kappa 0.611) had corresponding results in 6-[18F]FDOPA PET and SWI. Seven of the remaining 8 patients were correctly diagnosed by 6-[18F]FDOPA PET alone. Sensitivity, specificity and accuracy for 6-[18F]FDOPA and N1 imaging were 93%, 94%, 93% and 82%, 75%, 79%, respectively. Conclusions 6-[18F]FDOPA PET and Nigrosome 1 evaluation had an overall good intermodality agreement. Diagnostic agreement was very good in cases of clinically suspected idiopathic Parkinson syndrome and fair in atypical parkinsonian syndromes, but poor in patients with non-parkinsonian disorders. 6-[18F]FDOPA PET showed higher sensitivity, specificity and accuracy in discriminating parkinsonian syndromes from non-parkinsonian disorders than the N1 evaluation. In summary, the additional benefit of N1 assessment in patients with APS or parkinsonism without dopaminergic deficit needs to be proven by prospective studies.

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Section: Discussioncontrasting

confidence: 79%

Comparison of 6-[18F]FDOPA PET with Nigrosome 1 detection in patients with parkinsonism

et al. 2021

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“…Both the MAG and the SWI reconstructions of the single-echo FLASH sequence were found to be more sensitive to movement artefacts than FLAIR. The vulnerability of SWI to motion artefacts is known 36 and has also been reported by other studies on nigral hyperintensity 9 , 37 . EPISEG was rated as less sensitive to motion compared to MEDIC, MAG, and SWI techniques.…”

Section: Discussionsupporting

confidence: 63%

“…Most of the previous studies reported higher scores (i.e. mean, median, minimum or lower and upper quartile) for MDS-UPDRS Part III 37 or UPDRS Part III and/or UPDRS Part II 9 – 12 , 16 , 17 , 20 , 22 , 23 , 44 , 46 than the corresponding scores of our patients, which may also increase the sensitivity. Sung et al 16 included 89 early-stage (H&Y1 and H&Y2) PD patients without false-negative interpretation, but the median, the lower and the upper quartiles of their UPDRS II and III scores were all higher than in our patients.…”

Section: Discussioncontrasting

confidence: 41%

“…Previous studies have usually not specified the exact proportions of H&Y1 and H&Y2 patients 3 , 9 , 12 , 15 , 18 , 21 , 23 , 26 , 37 , 44 , 45 , but most of them reported higher mean H&Y score than our one 3 , 9 , 15 , 18 , 23 , 37 , 44 , 45 , which may increase the sensitivity. Others included a relatively lower number of H&Y1 PD cases 10 , 11 , 46 , which may hinder the comparison with our study.…”

Section: Discussionmentioning

confidence: 67%

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Fast 3 T nigral hyperintensity magnetic resonance imaging in Parkinson’s disease

Hernadi

Pintér

Nagy

et al. 2021

Sci Rep

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The absence of nigral hyperintensity is a promising MR marker for Parkinson’s disease (PD), but its small size imposes limitations on its routine use. Our aim was to compare Multi Echo Data Image Combination (MEDIC), segmented echo-planar imaging (EPISEG) and fluid-attenuated inversion recovery (FLAIR) sequences, as well as both magnitude (MAG) and susceptibility-weighted imaging (SWI) reconstructions of single-echo gradient echo for nigral hyperintensity imaging. Twenty-five healthy and twenty PD subjects were included. Sensitivity to motion artefacts, confidence of the radiologist in interpretation, rate of nondiagnostic scans and diagnostic accuracy were assessed. EPISEG was less motion-sensitive than MEDIC, MAG, and SWI, while FLAIR was less motion-sensitive than MAG and SWI. The reviewers were more confident when using EPISEG compared to any other techniques and MEDIC was superior to FLAIR. The proportions of nondiagnostic scans were lower for EPISEG than for other sequences. The best diagnostic performance was achieved for EPISEG (sensitivity = 65%, specificity = 96%). Using EPISEG, the absence of nigral hyperintensity in PD was associated with higher Hoehn-Yahr stage and MDS-UPDRS II + III. Nigral hyperintensity may be intact at the very early stages of PD. The promising properties of EPISEG may help the transfer of nigral hyperintensity imaging into daily clinical practice.

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“…In this regard, there has been a recent surge of interest in the field of biomarkers for PD. One such recently studied in vivo imaging biomarker is the Nigrosome imaging on 3T and 7T magnetic resonance imaging (MRI) sequences 6–8 . Based on calbindin D 28k immunostaining patterns, the dopaminergic neurons in the substantia nigra pars compacta are divided into calbindin rich regions (matrix) and calbindin poor regions known as a nigrosome.…”

mentioning

confidence: 99%

Utility of Imaging of Nigrosome‐1 on 3T MRI and Its Comparison with 18F‐DOPA PET in the Diagnosis of Idiopathic Parkinson Disease and Atypical Parkinsonism

Kathuria

Mehta

Ahuja

et al. 2020

Movement Disord Clin Pract

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Background Loss of nigrosome‐1 on 3T and 7T magnetic resonance imaging (MRI) is a recently explored imaging biomarker in the diagnosis of neurodegenerative parkinsonism. Objectives This study was undertaken to evaluate the utility of imaging of nigrosome in the diagnosis of neurodegenerative parkinsonism on 3T MRI. Methods An institution‐based prospective case–control study was conducted at a tertiary care center in North India. 3T venous blood oxygen level‐dependent (VenoBOLD) and high‐resolution susceptibility‐weighted imaging (SWI) imaging sequences in MRI were performed in 100 patients with parkinsonism (56 with idiopathic Parkinson's disease [IPD], 30 with young onset Parkinson's disease [YOPD], 12 with progressive supranuclear palsy, and 2 patients with multiple system atrophy) and 15 controls. Grading of nigrosome was done in both the sequences. Each patient underwent 18F‐DOPA positron emission tomography (PET), detailed neurological examination including Hoen and Yahr (H&Y) staging and Movement Disorder Society‐Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS‐UPDRS) scoring. Results The diagnostic sensitivity and specificity of the detection of loss of nigrosome‐1 on VenoBOLD and SWI sequence at 3T MR imaging were 90% and 66.7% and 94% and 80%, respectively. A weak negative correlation was found between the grading of the nigrosome and clinical parameters (H&Y and UPDRS III). There was no correlation between the side of nigrosome loss and clinical asymmetry. However, nigrosome imaging was not able to differentiate between Parkinson's disease and atypical parkinsonism. Conclusions The loss of nigrosome‐1 on 3T MRI on SWI and VenoBOLD sequences may serve as a potential imaging marker in the diagnosis of degenerative parkinsonian syndromes. However, it cannot differentiate between idiopathic Parkinson's disease and atypical parkinsonian syndromes.

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Accuracy of nigrosome-1 detection to discriminate patients with Parkinson’s disease and essential tremor

Cited by 24 publications

References 35 publications

Comparison of 6-[18F]FDOPA PET with Nigrosome 1 detection in patients with parkinsonism

Comparison of 6-[18F]FDOPA PET with Nigrosome 1 detection in patients with parkinsonism

Fast 3 T nigral hyperintensity magnetic resonance imaging in Parkinson’s disease

Utility of Imaging of Nigrosome‐1 on 3T MRI and Its Comparison with 18F‐DOPA PET in the Diagnosis of Idiopathic Parkinson Disease and Atypical Parkinsonism

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