Motor‐related circuit dysfunction in MSA‐P: Usefulness of combined whole‐brain imaging analysis

Tir, Mélissa; Delmaire, Christine; Thuc, Vianney Le; Duhamel, Alain; Destée, Alain; Pruvo, Jean‐Pierre; Defebvre, Luc

doi:10.1002/mds.22463

Cited by 37 publications

(32 citation statements)

References 49 publications

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“…This is particularly obvious when images of patients with symptoms dominant on the left side are flipped horizontally to match those of patients with right-sided clinical dominance. This finding is congruent with prior studies reporting changes in the left cerebral hemisphere and the right cerebellum in MSAp [23,33]. Congruently, our results suggest morphological alterations on the cerebral hemisphere contralateral to the dominating clinical symptoms.…”

Section: Discussionsupporting

confidence: 83%

“…In MSAp there is evidence for atrophy both of the putamen itself and the periputaminal internal capsule [8,9,23], which may occur in parallel. Furthermore, degeneration of the corticospinal tract would be concordant with the finding of decreased FA of the primary motor cortex [33], implying that MSAp affects pyramidal motor pathways earlier and stronger than PD. While VBM analysis of our data did not demonstrate significant macroscopic group-specific atrophy, this aspect should be evaluated in a larger sample.…”

Section: Discussionmentioning

confidence: 71%

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Diffusion Tensor Imaging in Idiopathic Parkinson's Disease and Multisystem Atrophy (Parkinsonian Type)

Cnyrim¹,

Kupsch

Ebersbach

et al. 2013

Neurodegener Dis

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Background: Differentiation between Parkinson's disease (PD) and atypical Parkinson syndromes (AP) is usually based on clinical examination, but can be challenging especially at early stages of the diseases. Diffusion tensor imaging (DTI) allows for differentiation between PD and AP with good specificity. It is a promising tool for clinical application, but has not been elaborated completely with respect to methodology and validity. Objective: In this study we evaluated differences of the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) within white brain matter between patients with PD and multisystem atrophy of the parkinsonian type (MSAp). Materials and Methods: DTI data of 9 PD and 9 MSAp patients were compared by means of a hypothesis-free whole-brain analysis algorithm (TBSS) focusing on changes within white matter. Results: We found significantly higher values of the ADC in the MSAp group in the anterior limb of the inner capsule, superior parts of the corona radiata, and lateral periputaminal white matter. Group differences in FA values were not significant. Conclusion: Changes of the ADC close to the putamen proved most consistent and seem to be promising for the ongoing clinical implementation of DTI for the differentiation of hypokinetic-rigid movement disorders.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 71%

Diffusion Tensor Imaging in Idiopathic Parkinson's Disease and Multisystem Atrophy (Parkinsonian Type)

Cnyrim¹,

Kupsch

Ebersbach

et al. 2013

Neurodegener Dis

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“…Four of these focused on ROIs in the middle cerebellar peduncles, detecting reduced FA. 7,33,35,37 Three studies found an increase in MCP diffusivity measures 7,23,38 ; one other VBA study 36 detected no significant diffusivity differences. One study examined the putamen in MSA finding FA reduced and ADC increased 8 ; another found elevated FA.…”

Section: Resultsmentioning

confidence: 99%

Diffusion tensor imaging in parkinsonian syndromes

2013

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Objectives: We performed a systematic review to assess alterations in measures of diffusion tensor imaging (DTI) in parkinsonian syndromes, exploring the potential role of DTI in diagnosis and as a candidate biomarker. Methods:We searched EMBASE and Medline databases for DTI studies comparing parkinsonian syndromes or related dementias with controls or another defined parkinsonian syndrome. Key details for each study regarding participants, imaging methods, and results were extracted. Estimates were pooled, where appropriate, by random-effects meta-analysis. Results:Of 333 results, we identified 43 studies suitable for inclusion (958 patients, 764 controls). DTI measures detected alterations in all parkinsonian syndromes, with distribution varying differentially with disease type. Nine studies were included in a meta-analysis of the substantia nigra in Parkinson disease. A notable effect size was found for lowered fractional anisotropy in the substantia nigra for patients with Parkinson disease vs controls (20.639, 95% confidence interval 20.860 to 20.417, p , 0.0001).Conclusion: DTI may be a promising biomarker in parkinsonian syndromes and have a future role in differential diagnosis. Larger cohort studies are required to investigate some encouraging preliminary findings. Given the complexity of the parkinsonian syndromes, it is likely that any potential DTI biomarker would be used in combination with other relevant biomarkers. Differences in natural history and therapy options make early and accurate diagnosis of parkinsonian syndromes important. 1 Emission tomography (SPECT or PET) has a role but it can be expensive, with limited availability, and requires radioactive tracers. 2 There is particular interest in the potential of advanced structural MRI techniques to differentiate among parkinsonian syndromes and to offer candidate biomarkers, facilitating early or premanifest diagnosis and monitoring of disease progression.Diffusion tensor imaging (DTI) is an MRI technique assessing the orientation and integrity of white matter tracts in vivo by measuring the diffusion of water molecules in neural fibers 3 and it also shows promise for studying gray matter areas. It estimates both the degree of directionality using anisotropy (frequently fractional anisotropy [FA]) and the overall movement of molecules (mean diffusivity [MD]; trace; apparent diffusion coefficient [ADC]). These measurements can either be extracted locally in predefined regions using region of interest (ROI) analysis or tractography or, alternatively, globally using voxel-based analysis (VBA) or tract-based spatial statistics (TBSS). Disruptions to microstructural tissue integrity, such as those found in the neurodegeneration of parkinsonian syndromes can be associated with alterations in anisotropy and diffusivity measures. 3 We therefore performed a systematic review of the literature to assess

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“…[34][35][36] A few studies found more local reduction of GM in PD, although the regions were inconsistent across the studies. 37,38 In addition, some reports showed no differences between PD and controls. 39,40 Differences in the relative representation of the PIGD and TD subtypes may explain the disparate findings in these earlier reports.…”

Section: Resultsmentioning

confidence: 99%

Gray matter atrophy distinguishes between Parkinson disease motor subtypes

Rosenberg‐Katz

Herman²,

Jacob³

et al. 2013

Neurology

144

110

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Objective: To assess differences in gray matter (GM) atrophy between 2 Parkinson disease (PD) subtypes: the tremor dominant (TD) subtype and the postural instability gait difficulty (PIGD) subtype.Methods: Patients were classified as belonging to the predominately PIGD (n 5 30) or predominately TD (n 5 29) subtype. Voxel-based morphometry was used to compare GM in these 2 subtypes and to evaluate correlations between predefined regions of interest and the degree of symptoms. In the regions where GM atrophy was associated with symptoms, the relationship between GM volumes and functional connectivity was examined.Results: GM was reduced in the predominately PIGD group, compared with the predominately TD group, in areas that involve motor, cognitive, limbic, and associative functions (p , 0.05, false discovery rate corrected). Lower GM volumes in the pre-supplementary motor area (SMA) and in the primary motor area were associated with increased severity of PIGD symptoms (r 5 20.42, p , 0.001; r 5 20.38, p , 0.003, respectively). Higher GM volumes within the pre-SMA were associated with stronger functional connectivity between the pre-SMA and the putamen (r 5 0.415, p , 0.025) in the patients with predominately PIGD. Conclusions:In patients with PD, PIGD symptoms are apparently associated with GM atrophy in motor-related regions and decreased functional connectivity. GM degeneration and a related decrease in spontaneous coactivation between cortical and subcortical motor-planning areas may partially account for the unique clinical characteristics of a subset of patients with PD.

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Motor‐related circuit dysfunction in MSA‐P: Usefulness of combined whole‐brain imaging analysis

Cited by 37 publications

References 49 publications

Diffusion Tensor Imaging in Idiopathic Parkinson's Disease and Multisystem Atrophy (Parkinsonian Type)

Diffusion Tensor Imaging in Idiopathic Parkinson's Disease and Multisystem Atrophy (Parkinsonian Type)

Diffusion tensor imaging in parkinsonian syndromes

Gray matter atrophy distinguishes between Parkinson disease motor subtypes

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