Quantitative Validation of a Visual Rating Scale for Defining High-Iron Putamen in Patients With Multiple System Atrophy

Lee, Myung Sik; Kim, Tae-Hyung; Kim, Seungjoo; Kim, Baik-Kyun; Mun, Chi-Woong; Lee, Jae‐Hyeok

doi:10.3389/fneur.2019.01014

Cited by 5 publications

(4 citation statements)

References 22 publications

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“…To assess basal ganglia atrophy in ICH patients with clinical-grade MRI scans not suitable for FreeSurfer-based volumetric measurement, we developed a metric based on the sum of the widths of three basal ganglia substructures-the caudate nucleus, putamen, and globus pallidus-normalized to the intracranial diameter (Figure 1). The measurement was obtained from the axial slice containing the largest area of the putamen, anterior commissure, septum pellucidum, and the pulvinar of thalamus 28 in the ICH-free hemisphere of each subject's axial T1-weighted sequence. An experienced rater (P.F.)…”

Section: Normalized Basal Ganglia Widthmentioning

confidence: 99%

Decreased Basal Ganglia Volume in Cerebral Amyloid Angiopathy

et al. 2021

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Background and Purpose Cerebral amyloid angiopathy (CAA) is a common pathology of the leptomeningeal and cortical small vessels associated with hemorrhagic and non-hemorrhagic brain injury. Given previous evidence for CAA-related loss of cortical thickness and white matter volume, we hypothesized that CAA might also cause tissue loss in the basal ganglia.Methods We compared basal ganglia volumes expressed as a percentage of total intracranial volume (pBGV) of non-demented patients with sporadic and hereditary CAA to age-matched healthy control (HC) and Alzheimer’s disease (AD) cohorts.Results Patients with sporadic CAA had lower pBGV (n=80, 1.16%±0.14%) compared to HC (n=80, 1.30%±0.13%, P<0.0001) and AD patients (n=80, 1.23%±0.11%, P=0.001). Similarly, patients with hereditary CAA demonstrated lower pBGV (n=25, 1.26%±0.17%) compared to their matched HC (n=25, 1.36%±0.15%, P=0.036). Using a measurement of normalized basal ganglia width developed for analysis of clinical-grade magnetic resonance images, we found smaller basal ganglia width in patients with CAA-related lobar intracerebral hemorrhage (ICH; n=93, 12.35±1.47) compared to age-matched patients with hypertension-related deep ICH (n=93, 13.46±1.51, P<0.0001) or HC (n=93, 15.45±1.22, P<0.0001). Within the sporadic CAA research cohort, decreased basal ganglia volume was independently correlated with greater cortical gray matter atrophy (r=0.45, P<0.0001), increased basal ganglia fractional anisotropy (r=–0.36, P=0.001), and worse performance on language processing (r=0.35, P=0.003), but not with cognitive tests of executive function or processing speed.Conclusions These findings suggest an independent effect of CAA on basal ganglia tissue loss, indicating a novel mechanism for CAA-related brain injury and neurologic dysfunction.

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Section: Normalized Basal Ganglia Widthmentioning

confidence: 99%

Decreased Basal Ganglia Volume in Cerebral Amyloid Angiopathy

et al. 2021

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“…In general, our ground truth labels matched the range of putamen volume in HC, MSA, and PD of previous studies [ 12 , 24 – 29 ]. In comparison with ground truth labels, we observed that the AAL3 algorithm tended to overestimate the volume of the putamen, whereas Freesurfer and Fastsurfer tended to underestimate it.…”

Section: Discussionmentioning

confidence: 68%

Deep learning segmentation results in precise delineation of the putamen in multiple system atrophy

et al. 2023

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Objectives The precise segmentation of atrophic structures remains challenging in neurodegenerative diseases. We determined the performance of a Deep Neural Patchwork (DNP) in comparison to established segmentation algorithms regarding the ability to delineate the putamen in multiple system atrophy (MSA), Parkinson’s disease (PD), and healthy controls. Methods We retrospectively included patients with MSA and PD as well as healthy controls. A DNP was trained on manual segmentations of the putamen as ground truth. For this, the cohort was randomly split into a training (N = 131) and test set (N = 120). The DNP’s performance was compared with putaminal segmentations as derived by Automatic Anatomic Labelling, Freesurfer and Fastsurfer. For validation, we assessed the diagnostic accuracy of the resulting segmentations in the delineation of MSA vs. PD and healthy controls. Results A total of 251 subjects (61 patients with MSA, 158 patients with PD, and 32 healthy controls; mean age of 61.5 ± 8.8 years) were included. Compared to the dice-coefficient of the DNP (0.96), we noted significantly weaker performance for AAL3 (0.72; p < .001), Freesurfer (0.82; p < .001), and Fastsurfer (0.84, p < .001). This was corroborated by the superior diagnostic performance of MSA vs. PD and HC of the DNP (AUC 0.93) versus the AUC of 0.88 for AAL3 (p = 0.02), 0.86 for Freesurfer (p = 0.048), and 0.85 for Fastsurfer (p = 0.04). Conclusion By utilization of a DNP, accurate segmentations of the putamen can be obtained even if substantial atrophy is present. This allows for more precise extraction of imaging parameters or shape features from the putamen in relevant patient cohorts. Clinical relevance statement Deep learning-based segmentation of the putamen was superior to currently available algorithms and is beneficial for the diagnosis of multiple system atrophy. Key Points • A Deep Neural Patchwork precisely delineates the putamen and performs equal to human labeling in multiple system atrophy, even when pronounced putaminal volume loss is present. • The Deep Neural Patchwork–based segmentation was more capable to differentiate between multiple system atrophy and Parkinson’s disease than the AAL3 atlas, Freesurfer, or Fastsurfer.

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“…In particular, iron accumulation in the posterior inner region of the putamen is specific for MSA 27 . A visual rating scale for putaminal hypointensities can be useful for evaluation of patients with MSA‐P as it correlates with R2*, volume loss, and motor scores 28 …”

Section: Resultsmentioning

confidence: 99%

Can Autonomic Testing and Imaging Contribute to the Early Diagnosis of Multiple System Atrophy? A Systematic Review and Recommendations by the Movement Disorder Society Multiple System Atrophy Study Group

Pellecchia

Stanković

Fanciulli

et al. 2020

Movement Disord Clin Pract

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Background Background: In the current consensus diagnostic criteria, the diagnosis of probable multiple system atrophy (MSA) is based solely on clinical findings, whereas neuroimaging findings are listed as aid for the diagnosis of possible MSA. There are overlapping phenotypes between MSA-parkinsonian type and Parkinson's disease, progressive supranuclear palsy, and dementia with Lewy bodies, and between MSA-cerebellar type and sporadic adult-onset ataxia resulting in a significant diagnostic delay and misdiagnosis of MSA during life. Objectives Objectives: In light of an ongoing effort to revise the current consensus criteria for MSA, the Movement Disorders Society Multiple System Atrophy Study Group performed a systematic review of original articles published before August 2019. Methods Methods: We included articles that studied at least 10 patients with MSA as well as participants with another disorder or control group for comparison purposes. MSA was defined by neuropathological confirmation, or as clinically probable, or clinically probable plus possible according to consensus diagnostic criteria. Results Results: We discuss the pitfalls and benefits of each diagnostic test and provide specific recommendations on how to evaluate patients in whom MSA is suspected. Conclusions Conclusions: This systematic review of relevant studies indicates that imaging and autonomic function tests significantly contribute to increasing the accuracy of a diagnosis of MSA.

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Quantitative Validation of a Visual Rating Scale for Defining High-Iron Putamen in Patients With Multiple System Atrophy

Cited by 5 publications

References 22 publications

Decreased Basal Ganglia Volume in Cerebral Amyloid Angiopathy

Decreased Basal Ganglia Volume in Cerebral Amyloid Angiopathy

Deep learning segmentation results in precise delineation of the putamen in multiple system atrophy

Can Autonomic Testing and Imaging Contribute to the Early Diagnosis of Multiple System Atrophy? A Systematic Review and Recommendations by the Movement Disorder Society Multiple System Atrophy Study Group

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