Substantia nigra fractional anisotropy is not a diagnostic biomarker of Parkinson’s disease: A diagnostic performance study and meta-analysis

Hirata, Fabiana Campos; Sato, João Ricardo; Vieira, Gilson; Lucato, Leandro Tavares; Leite, Cláudia C.; Bor‐Seng‐Shu, Edson; Pastorello, Bruno Fraccini; Otaduy, Maria C. G.; Chaim, Khallil Taverna; Campanholo, Kenia Repiso; Novaes, Natalia P.; Melo, Luciano Magalhães; Gonçalves, Mauro; Nascimento, Felipe Barjud Pereira do; Teixeira, Manoel Jacobsen; Barbosa, Egberto Reis; Amaro, Edson; Cardoso, Ellison Fernando

doi:10.1007/s00330-016-4611-0

Cited by 26 publications

(18 citation statements)

References 43 publications

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“…The authors proposed that FA measurements in the caudal and lateral subregions of the SN, presumably coinciding with the histological described SNc location (ROI subdivision Type B1), have the best diagnostic value for PD. However, eight subsequent studies with the same SN subdivision (subdivision Type B) reported discrepant findings: two studies (13, 132) likely replicated the findings of FA reduction in the dorsal lateral sub-region of the SN in PD; five other studies (7,8,55,104,131) found no significant FA differences between PD and HC in any SN sub-region; and one (130) reported elevated FA in all the SN sub-regions in PD. Technical difficulties outlining the sub-regions may explain these discrepant findings.…”

Section: Dti Changes In Sn and Sn Subdivisionsmentioning

confidence: 99%

“…Table 4 lists 32 independent studies that analyzed DTI in the total SN area and SN sub-regions in order to identify substantial DTI alterations in patients with PD. These studies were included in four previous meta-analyses and reviews (104,131,135,136 Table 4) is sensitive to capture the dopamine loss in PD. Molecular and neuropathological studies (137) of PD have highlighted that progressive loss of dopaminergic neurons is primarily involved in the pars compacta (SNc), which contains rich pigment neuromelanin formed by dopaminergic neurons, and lies in the inferior and posterior part of the SN, in contrast to the pars reticulata (SNr), which lies lateral to the SNc.…”

Section: Dti Changes In Sn and Sn Subdivisionsmentioning

confidence: 99%

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Diffusion Tensor Imaging in Parkinson's Disease and Parkinsonian Syndrome: A Systematic Review

Zhang

Burock

2020

Front. Neurol.

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Section: Dti Changes In Sn and Sn Subdivisionsmentioning

confidence: 99%

Section: Dti Changes In Sn and Sn Subdivisionsmentioning

confidence: 99%

Diffusion Tensor Imaging in Parkinson's Disease and Parkinsonian Syndrome: A Systematic Review

Zhang

Burock

2020

Front. Neurol.

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“…Metrics changes in SN are controversial. Previous studies have demonstrated conflicting observations in SN, such as an increased (Van Camp et al, 2009;Wang et al, 2011;Lenfeldt et al, 2015), decreased (Boska et al, 2007;Vaillancourt et al, 2009;Langley et al, 2016;Loane et al, 2016), or unaltered (Schuff et al, 2015;Hirata et al, 2017;Pelizzari et al, 2019) FA in PD patients. Our study showed an increased FA in SN in PD patients, which was consistent with some of the previous studies (Van Camp et al, 2009;Wang et al, 2011;Lenfeldt et al, 2015), but inconsistent with other studies (Boska et al, 2007;Vaillancourt et al, 2009;Langley et al, 2016;Loane et al, 2016).…”

Section: Discussionmentioning

confidence: 95%

Mean Apparent Propagator MRI Is Better Than Conventional Diffusion Tensor Imaging for the Evaluation of Parkinson’s Disease: A Prospective Pilot Study

Zeng

Zhang

et al. 2020

Front. Aging Neurosci.

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Background and Purpose: Mean apparent propagator (MAP) MRI is a novel diffusion imaging method to map tissue microstructure. The purpose of this study was to evaluate the diagnostic value of the MAP MRI in Parkinson's disease (PD) in comparison with conventional diffusion tensor imaging (DTI). Methods: 23 PD patients and 22 age-and gender-matched healthy controls were included. MAP MRI and DTI were performed on a 3T MR scanner with a 20-channel head coil. The MAP metrics including mean square displacement (MSD), return to the origin probability (RTOP), return to the axis probability (RTAP), and return to the plane probability (RTPP), and DTI metrics including fractional anisotropy (FA), and mean diffusivity (MD), were measured in subcortical gray matter and compared between the two groups. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic performance of all the metrics. The association between the diffusion metrics and disease severity was assessed by Pearson correlation analysis. Results: For MAP MRI, the mean values of MSD in the bilateral caudate, pallidum, putamen, thalamus and substantia nigra (SN) were higher in PD patients than in healthy controls (p FDR ≤ 0.001); the mean values of the zero displacement probabilities (RTOP, RTAP, and RTPP) in the bilateral caudate, pallidum, putamen and thalamus were lower in PD patients (p FDR < 0.001). For DTI, only FA in the bilateral SN was significantly higher in PD patients than those in the controls (p FDR < 0.001). ROC analysis showed that the areas under the curves of MAP MRI metrics (MSD, RTOP, RTAP, and RTPP) in the bilateral caudate, pallidum, putamen and thalamus (range, 0.85-0.94) were greater than those of FA and MD of DTI (range, 0.55-0.69) in discriminating between PD patients and September 2020 | Volume 12 | Article 563595 Le et al. MAP MRI in PD healthy controls. RTAP in the ipsilateral pallidum (r = −0.56, p FDR = 0.027), RTOP in the bilateral and contralateral putamen (r = −0.58, p FDR = 0.019; r = −0.57, p FDR = 0.024) were negatively correlated with UPDRS III motor scores. Conclusion: MAP MRI outperformed the conventional DTI in the diagnosis of PD and evaluation of the disease severity.

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“…There are conflicting findings concerning the usefulness of SN DTI metrics in PD diagnosis, according to recent metaanalyses (45)(46)(47) and recent voxelwise analysis-based studies concerning the whole SN (48)(49)(50). Fractional Anisotropy (FA) in the posterior part seems to be the most discriminant feature (51,52).…”

Section: Diffusion Weighted Imaging Diffusion Tensor Imaging (Dti)mentioning

confidence: 99%

Modern Brainstem MRI Techniques for the Diagnosis of Parkinson's Disease and Parkinsonisms

2020

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The brainstem is the earliest vulnerable structure in many neurodegenerative diseases like in Multiple System Atrophy (MSA) or Parkinson's disease (PD). Up-to-now, MRI studies have mainly focused on whole-brain data acquisition. Due to its spatial localization, size, and tissue characteristics, brainstem poses particular challenges for MRI. We provide a brief overview on recent advances in brainstem-related MRI markers in Parkinson's disease and Parkinsonism's. Several MRI techniques investigating brainstem, mainly the midbrain, showed to be able to discriminate PD patients from controls or to discriminate PD patients from atypical parkinsonism patients: iron-sensitive MRI, nigrosome imaging, neuromelanin-sensitive MRI, diffusion tensor imaging and advanced diffusion imaging. A standardized multimodal brainstem-dedicated MRI approach at high resolution able to quantify microstructural modification in brainstem nuclei would be a promising tool to detect early changes in parkinsonian syndromes.

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Substantia nigra fractional anisotropy is not a diagnostic biomarker of Parkinson’s disease: A diagnostic performance study and meta-analysis

Abstract: • SN-FA appears insufficiently sensitive and specific to diagnose PD. • Radiologists must be careful when translating mean group results to clinical practice. • Imaging protocol and analysis standardization is necessary for developing reproducible quantitative biomarkers.

Cited by 26 publications

References 43 publications

Diffusion Tensor Imaging in Parkinson's Disease and Parkinsonian Syndrome: A Systematic Review

Diffusion Tensor Imaging in Parkinson's Disease and Parkinsonian Syndrome: A Systematic Review

Mean Apparent Propagator MRI Is Better Than Conventional Diffusion Tensor Imaging for the Evaluation of Parkinson’s Disease: A Prospective Pilot Study

Modern Brainstem MRI Techniques for the Diagnosis of Parkinson's Disease and Parkinsonisms

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