Advanced diffusion imaging to track progression in Parkinson’s disease, multiple system atrophy, and progressive supranuclear palsy

Mitchell, Trina; Wilkes, Bradley J.; Archer, Derek B.; Chu, Winston T.; Coombes, Stephen; Lai, Song; McFarland, Nikolaus R.; Okun, Michael S.; Black, Mieniecia L.; Herschel, Ellen; Simuni, Tanya; Comella, Cynthia L.; Afshari, Mitra; Xie, Tao; Li, Hong; Parrish, Todd B.; Kurani, Ajay S.; Corcos, Daniel M.; Vaillancourt, David E.

doi:10.1016/j.nicl.2022.103022

Cited by 15 publications

(30 citation statements)

References 60 publications

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“…In this study, RBD was the first symptom of MSA, which precede motor symptoms onset by a mean of 2.81 ± 4.51 years (median, 1 year). Previous studies have indicated that RBD is likely the first symptom of MSA ( 40 , 44 ), and one study has shown that RBD precedes the disease onset with a median time of 3 ( 2 – 5 ) years ( 40 ). These studies were generally consistent with our findings.…”

Section: Discussionmentioning

confidence: 99%

“…Parkinson's disease (PD) and progressive supranuclear palsy (PSP) are two other neurodegenerative disorders that share parkinsonian clinical features with MSA ( 4 ). Due to overlapping motor symptoms, the differential diagnosis of MSA from PD and PSP is difficult, especially at the early stages of the disease ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

“…To date, 12 studies have reported RBD preceding the clinical MSA onset, and the prevalence of RBD as the first symptom of disease onset ranged from 10.0 to 60.0% when calculated in overall MSA cases ( 44 ). A large monocentric study on 158 patients with MSA shows that RBD was the most frequent first symptom of MSA, preceding the disease onset by a median of 3 ( 2 – 5 ) years ( 40 ). While another retrospective study of 30 patients with MSA showed that RBD was the third most frequent initial symptom of MSA, after complete erectile failure and postural lightheadedness ( 43 ).…”

Section: Introductionmentioning

confidence: 99%

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Non-motor symptoms in multiple system atrophy: A comparative study with Parkinson's disease and progressive supranuclear palsy

Cao

Yin

et al. 2023

Front. Neurol.

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BackgroundNon-motor symptoms (NMS) are compulsory clinical features for the clinical diagnosis of multiple system atrophy (MSA), some of which precede motor symptoms onset. To date, few studies have systematically investigated NMS in MSA and the timing of presenting NMS as the disease progresses. Clinically, MSA is difficult to be differentiated from Parkinson's disease (PD) and progressive supranuclear palsy (PSP), and the differences in NMS between MSA and PD/PSP remain unclear. The aim of this study was to compare the burden of NMS between MSA and PD/PSP and to delineate the timing of NMS presentation relative to the onset of motor symptoms in MSA.MethodsA total of 61, 87, and 30 patients with MSA, PD, and PSP, respectively, were enrolled in this study. NMS was systematically assessed in all patients using the NMS scale (NMSS), and the onset of NMS relative to the onset of motor symptoms in MSA was investigated.ResultsMSA group had higher total NMSS scores (82.15 ± 46.10) than the PD (36.14 ± 30.78) and PSP (50.30 ± 55.05) groups (p < 0.001 overall). The number distribution pattern of the NMS was significantly different among the three parkinsonian disorders (p < 0.001 overall). In total, 85.2% of patients with MSA had more than 10 NMS, which was significantly higher than PD (28.7%) and PSP (33.3%). The frequency and scores of many NMSS subdomains and symptoms were higher in MSA than in PD and PSP (all p < 0.05). Multivariate logistic regression analysis revealed that patients with fainting, lack of motivation, swallowing, and loss of sexual interest could be attributed to MSA rather than PD or PSP, while patients with loss of concentration and forgetfulness were characteristic features of PD or PSP rather than MSA. REM-sleep behavior disorder (RBD), constipation, problems having sex, and loss of sexual interest preceded the motor symptoms onset of MSA by 2.81 ± 4.51, 1.54 ± 6.32, 1.35 ± 4.70, and 0.45 ± 3.61 years, respectively.ConclusionThe NMS spectrum in MSA differs from that of PD and PSP. Patients with MSA have a higher NMS burden than patients with PD or PSP. RBD, constipation, problems having sex, and loss of sexual interest may become early diagnostic clinical markers of MSA.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Non-motor symptoms in multiple system atrophy: A comparative study with Parkinson's disease and progressive supranuclear palsy

Cao

Yin

et al. 2023

Front. Neurol.

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“…A novel diffusion MRI technique called fixel-based analysis combines voxel-based analysis with tract-based analysis to address the problem of crossing fibers within a voxel. Using FW, NODDI, and fixel-based analysis 1-year change in diffusion measures and their association with clinical disease progression were examined in PD, MSA-P, and PSP ( 58 ). Only the fixel-based analysis and FW imaging revealed longitudinal declines in a larger number of descending sensorimotor tracts in MSA-P and PSP compared to PD.…”

Section: Mri Modalitiesmentioning

confidence: 99%

Magnetic resonance imaging modalities aid in the differential diagnosis of atypical parkinsonian syndromes

Tinaz

2023

Front. Neurol.

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Accurate and timely diagnosis of atypical parkinsonian syndromes (APS) remains a challenge. Especially early in the disease course, the clinical manifestations of the APS overlap with each other and with those of idiopathic Parkinson's disease (PD). Recent advances in magnetic resonance imaging (MRI) technology have introduced promising imaging modalities to aid in the diagnosis of APS. Some of these MRI modalities are also included in the updated diagnostic criteria of APS. Importantly, MRI is safe for repeated use and more affordable and accessible compared to nuclear imaging. These advantages make MRI tools more appealing for diagnostic purposes. As the MRI field continues to advance, the diagnostic use of these techniques in APS, alone or in combination, are expected to become commonplace in clinical practice.

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“…One such marker, known as Free Water in the Substantia Nigra (pSN) has emerged as a reliable imaging biomarker for detecting Parkinsonism in early stages of the disease (Arpin et al, 2022;Zhou et al, 2021), and tracking disease progression (Guttuso et al, 2018;Ofori et al, 2015). Free water in the pSN is a valid imaging marker of neurodegeneration in idiopathic REM sleep behavior disorder, a preclinical model of parkinsonism (Fulda, 2011;Zhou et al, 2021), and can help to differentiate PD from people suffering from other synucleinopathies (Mitchell et al, 2022). However, imaging measures, such as Free Water in the pSN, are not employed as early screening tools due to the high-cost and lack of availability.…”

Section: Introductionmentioning

confidence: 99%

An Artificial Intelligence Video-Based Assessment of Upper-limb Bradykinesia in Parkinson’s Disease

Guarín

Wong

Ramirez‐Zamora

2023

Preprint

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As there is a lack of an objective biomarker for Parkinson’s disease (PD), the clinical practice relies on serial neurologic assessments to track and characterize disease progression. These clinical scales lack the resolution to detect subtle changes, classify the movements into broad categories, require significant expertise for proper application, and are not sensible enough for early diagnosis; imaging markers are objective and sensible for early diagnosis but are costly and not commonly available. The video-based movement measures estimated using AI algorithms for motion tracking represent a novel alternative for diagnosing and assessing PD. Video-based measures are objective, sensitive to small changes, inexpensive, and easily accessible. This paper explores the correlation between objective kinematics measures derived from videos of the Finger Tapping Test using AI-based algorithms for markerless motion tracking with well-established clinical and imaging markers of disease progression in PD. The results demonstrate that AI-based algorithms for markerless motion tracking accurately track hand movements during the Finger Tapping Test. Different movement aspects, such as speed, duration, amplitude, and rhythm alterations, can be quantified from the videos. Our analysis showed that these video-based measures were significantly correlated with clinical rating scales, including the Movement Disorder Society – Parkinson’s Disease Rating Scale Part III and its Finger Tapping subscore. Additionally, some measures significantly correlated with imaging markers, such as Free Water in the posterior Substantia Nigra. Furthermore, video-based measures could detect the presence of PD from the Finger Tapping Test videos with high accuracy. The best classification model achieved an average accuracy of 95% and an area under the receiver operating characteristic curve of 0.87. Finally, we introduce The Hand Tracking Tool, an easy-to-use interface for analyzing Finger Tapping Test videos using AI-based algorithms for markerless motion tracking and obtaining objective movement measures.

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Advanced diffusion imaging to track progression in Parkinson’s disease, multiple system atrophy, and progressive supranuclear palsy

Cited by 15 publications

References 60 publications

Non-motor symptoms in multiple system atrophy: A comparative study with Parkinson's disease and progressive supranuclear palsy

Non-motor symptoms in multiple system atrophy: A comparative study with Parkinson's disease and progressive supranuclear palsy

Magnetic resonance imaging modalities aid in the differential diagnosis of atypical parkinsonian syndromes

An Artificial Intelligence Video-Based Assessment of Upper-limb Bradykinesia in Parkinson’s Disease

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