Brain Magnetic Resonance Imaging in Multiple-System Atrophy and Parkinson Disease

Bhattacharya, Kirsty; Saadia, Daniela; Eisenkraft, Barbara; Yahr, Melvin D.; Olanow, Warren; Drayer, Burton P.; Kaufmann, Horacio

doi:10.1001/archneur.59.5.835

Cited by 137 publications

(129 citation statements)

References 23 publications

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“…The only exception was the midbrain area that was significantly different, with MSA-c showing lower values than MSA-p (p<0.01). In MSA-p cases, the measurements performed were not statistically satisfactory to differentiate from other parkinsonian patients, which is compatible with other studies [15][16][17] . Thus, MRI measures did not contribute for the differential diagnosis between MSA-c and other parkinsonian syndromes.…”

Section: Discussionsupporting

confidence: 88%

Morphometry MRI in the differential diagnosis of parkinsonian syndromes

Gama

Távora

Bomfim

et al. 2010

Arq. Neuro-Psiquiatr.

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This study evaluates the diagnostic value of morphometric magnetic resonance imaging (MRI) in the differential diagnosis among Parkinson's disease (PD), progressive supranuclear palsy (PSP) and multiple system atrophy (MSA). We studied 21 PD cases, 11 MSA-c, 8 MSA-p and 20 PSP cases. Midbrain area (Ams), pons area (Apn), middle cerebellar peduncle (MCP) and superior cerebellar peduncle (SCP) were measured using MRI. Comparisons were made between PD, MSA-p, MSA-c and PSP. Apn , MCP and SCP morphometry dimensions presented differences among groups. Ams below 105 mm 2 and SCP smaller than 3 mm were the most predictive measures of PSP (sensitivity 95.0 and 80.0%, respectively). For the group of MSA-c patients, Apn area below 315 mm 2 showed good specificity and positive predictive value (93.8% and 72.7%, respectively). In conclusion, dimensions and cut off values obtained from routine MRI can differentiate between PD, PSP and MSA-c with good sensitivity, specificity and accuracy. Key words: Parkinson, multiple system atrophy, progressive supranuclear palsy, magnetic resonance imaging, pons, midbrain. Morfometria por ressonância magnética no diagnóstico diferencial das síndromes parkinsonianas rEsUMOMorfometria pela ressonância magnética (RM) no diagnóstico diferencial entre doença de Parkinson (DP), paralisia supranuclear progressiva (PSP) e atrofia de múltiplos sistemas (AMS). Este estudo avaliou a RM no diagnóstico diferencial de 21 casos com DP, 11 AMS-c, 8 AMS-p e 20 com PSP. A área sagital do mesencéfalo (Ams), área sagital da ponte (Apn), largura do pedúnculo cerebelar médio (PCM) e pedúnculo cerebelar superior (PCS) foram medidas pela RM e realizadas comparações entre destes pacientes. A Ams <105 mm 2 e a largura média do PCS <3 mm foram preditivas para PSP (sensibilidade de 95,0 e 80,0%, respectivamente). Nos casos de AMS-c a área pontina <315 mm 2 apresentou boa especificidade e valor preditivo positivo para o diagnóstico (93,8% e 72,7%). Em conclusão, as dimensões e valores de cortes obtidos a partir da RM podem diferenciar PD, PSP e

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Section: Discussionsupporting

confidence: 88%

Morphometry MRI in the differential diagnosis of parkinsonian syndromes

Gama

Távora

Bomfim

et al. 2010

Arq. Neuro-Psiquiatr.

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“…This pattern of hypointensity has often been described as a marker of the parkinsonian variant of multiple system atrophy (MSA-P; 30) Kraft et al compared the frequency and specificity of T 2 putaminal hypointensity among PD, MSA-P, and progressive supranuclear palsy, finding that it occurred in each patient group and was not specific to MSA-P (31). Bhattacharya et al found putaminal hypointensity in both PD and MSA-P, but it was rated as milder in the PD patients (30). Putaminal hypointensity was the most sensitive but least specific parameter distinguishing MSA-P, with no significant difference between PD and MSA-P (32).…”

Section: Discussionmentioning

confidence: 99%

MRI assessment of basal ganglia iron deposition in Parkinson's disease

Wallis

Paley

Graham

et al. 2008

Magnetic Resonance Imaging

149

117

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Purpose:To estimate the levels of basal ganglia iron levels in Parkinson's disease (PD) using the PRIME MR sequence at 3.0 Tesla, in relation to patients' motor symptom severity. Materials and Methods:Seventy patients with PD and 10 healthy controls underwent assessment of movement and MR imaging. Mean R 2 Ј relaxation rates were recorded in the substantia nigra, frontal white matter and in the rostral, mid, and caudal putamen.Results: R 2 Ј relaxation rates were significantly higher in patients with PD than in healthy controls. R 2 Ј in the most affected substantia nigra correlated with PD patients' motor symptom severity, but not with disease duration. Neuroradiological observation revealed a rostral to caudal "gradient" of putaminal hypointensity. This was substantiated by the finding that the mid and caudal putamen showed significantly higher R 2 Ј relaxation rates, consistent with higher iron levels in PD relative to the healthy controls.Conclusion: MRI at 3.0 Tesla suggests that substantia nigra iron levels are increased and linked to the severity of motor symptoms experienced in PD. Findings consistent with increased iron levels in the PD putamen are shown, in a region-specific rostral to caudal gradient.

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“…5,6 Hyperintensities in the pons, middle cerebellar peduncles, and cerebellum, corresponding to pontocerebellar tract atrophy and hyper-and/or hypointensities associated with posterior putaminal atrophy on T2-weighted images, have been described as characteristic findings on MR images in patients with MSA. [7][8][9][10][11][12] Diffusion-weighted MR imaging (DWI) has emerged as a useful method for detecting early pathologic changes of various diseases based on water diffusivity. 13 Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values have been used to evaluate the degree of tissue degeneration in various disorders.…”

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confidence: 99%