Case control study of diffusion tensor imaging in Parkinson's disease

Chan, Ling‐Ling; Rumpel, Helmut; Yap, Karen; Lee, Esther; Loo, Hui-Voon; Ho, Gay Hui; Fook‐Chong, Stephanie; Yuen, Yin; Tan, Eng‐King

doi:10.1136/jnnp.2007.121525

Cited by 176 publications

(190 citation statements)

References 21 publications

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“…The current study extends the previous literature to show that early stage, de novo patients with PD have reduced FA in the SN. In addition, although group-level differences for FA in the SN were significant in both previous studies between patients with PD and control subjects, 4,6 on an individual basis, FA measures could not identify PD patients consistently. For instance, a case-controlled study 4 reported an area under the curve that was considered modest (0.653), suggesting that DTI may not be a promising method for identifying PD in individual subjects.…”

Section: Resultsmentioning

confidence: 57%

“…4,6 In those studies, patients were more severely impaired than the patients in the current study, and the patients in these two previous studies were examined while on dopaminergic medication. The current study extends the previous literature to show that early stage, de novo patients with PD have reduced FA in the SN.…”

Section: Resultsmentioning

confidence: 99%

“…Recent developments in neuroimaging techniques bring new promise for identifying surrogate markers of the degeneration within the SN in vivo. [4][5][6] Although diffusion tensor imaging (DTI) has typically been used to study white matter tracts, 7,8 it also holds promise for studying abnormalities in gray matter areas. As a method, DTI is based upon the diffusivity of water molecules, which exhibit a varying degree of tissue dependent anisotropy.…”

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confidence: 99%

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High-resolution diffusion tensor imaging in the substantia nigra of de novo Parkinson disease

et al. 2009

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Section: Resultsmentioning

confidence: 57%

Section: Resultsmentioning

confidence: 99%

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confidence: 99%

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High-resolution diffusion tensor imaging in the substantia nigra of de novo Parkinson disease

et al. 2009

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“…This study, along with another, 24 did not find an association between disease severity and FA in SN. Two other studies 10,26 did find reduced FA in SN correlated with disease severity. Studies focusing on the SN and integrating T2* 20,24 or volumetric analysis 15 with DTI reported that this improved their ability to discriminate patients with PD from healthy controls.…”

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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“…The most common finding in many DTI studies was a reduction in fractional anisotropy (FA) in the substantia nigra of PD patients (Chan et al, 2007;Du et al, 2011;Peran et al, 2010;Vaillancourt et al, 2009;Yoshikawa, Nakata, Yamada, & Nakagawa, 2004), and the reduction in FA values in the substantia nigra was inversely correlated with the severity of the clinical symptoms of PD patient (Chan et al, 2007). Extranigral WM changes have been observed in PD patients.…”

Section: Structural Connectivitymentioning

confidence: 99%