Diffusion Kurtosis Imaging for Detection of Early Brain Changes in Parkinson's Disease

Abstract

We aimed to evaluate microscale changes in the bilateral red nucleus and substantia nigra of patients with Parkinson's disease (PD) using diffusion kurtosis imaging (DKI). Twenty-six patients with PD [mean age, 62.5 ± 8.7 years; Hoehn-Yahr stage, 0-4.0; Unified Parkinson's Disease Rating Scale (UPDRS) scores, 8-43] and 15 healthy controls (mean age, 59.5 ± 9.4 years) underwent DKI of the substantia nigra and red nucleus. Imaging was performed using a General Electric (GE) Signa 3.0-T MRI system. Patients with PD were divided into two groups consisting of 12 patients with UPDRS scores ≥ 30 and 14 patients with UPDRS scores < 30. All DKI data processing operations were performed with commercial workstations (GE, ADW 4.6) using Functool software to generate color-coded and parametric maps of mean kurtosis (MK), fractional anisotropy (FA), and mean diffusivity (MD). MK values in the bilateral substantia nigra were significantly lower in patients with early-and advanced-stage PD than in controls. Moreover, MK values in the left substantia nigra were significantly lower in patients with advanced-stage PD than in those with early-stage PD. Patients with advanced-stage PD also exhibited significant decreases in MK values in the bilateral red nucleus relative to controls. No significant differences in FA or MD values were observed between the PD and control groups. There were no significant correlations between MK, FA, or MD values and UPDRS scores. Our findings suggest that decreased MK values in the substantia nigra may aid in determining the severity of PD and help provide early diagnoses.

Assessing White Matter Pathology in Early-Stage Parkinson Disease Using Diffusion MRI: A Systematic Review

“…They found differences in DTI and DKI metrics between PD subjects and HC in the putamen, thalamus, and superior longitudinal fasciculus, which were also associated with increased disease severity. Guan et al (42) used ROI analysis of DKI metrics to study advanced and early-stage PD, and MK was found to be significantly lower in bilateral SN in patients with both early-stage and advanced PD than in controls. In addition, MK in the left SN was significantly lower in patients with advanced PD than in those with earlystage PD.…”

Microstructural and Cerebral Blood Flow Abnormalities in Subjective Cognitive Decline Plus: Diffusional Kurtosis Imaging and Three-Dimensional Arterial Spin Labeling Study

“…FA is mostly used for assessing WM fiber tract integrity, and MD can assess microstructural alterations of GM and WM. DKI has shown great potential in diagnosing several disorders of the nervous system, such as neurodegenerative disease, brain infarction, gliomas, and mental illness (Guo et al, 2016 ; Zhao et al, 2016 ; Guan et al, 2019 ; Haopeng et al, 2020 ; Huang et al, 2020 ; McKenna et al, 2020 ). Previous studies have also reported that, in patients with MCI and AD, DKI can detect microstructural alterations in GM (Falangola et al, 2013 ; Gong et al, 2013 ; Struyfs et al, 2015 ; Chen et al, 2017 ), as well as in WM (Yuan et al, 2016 ; Gong et al, 2017 ; Song et al, 2019 ).…”

Diffusion Magnetic Resonance Imaging-Based Biomarkers for Neurodegenerative Diseases

“…Guan et al [ 102 ] showed decreased MK in bilateral SN in patients with early-stage (Unified PD Rating Scale [UPDRS]-III score <30) and advanced-stage (UPDRS-III score ≥30) PD compared to controls ( Figure 7 ). Moreover, patients with advanced-stage PD showed lower MK in the left SN compared to those with early-stage PD and lower MK in bilateral red nuclei compared to controls.…”

“…** p < 0.01, ASPD vs. CTL; * p < 0.05, ESPD vs. CTL, ASPD vs. CTL, and ASPD vs. ESPD. Abbreviations: ASPD, advanced-stage Parkinson’s disease; CTL, control; ESPD, early-stage Parkinson’s disease; FALSN, fractional anisotropy of left substantia nigra; FARSN, fractional anisotropy of right substantia nigra; MDLSN, mean diffusivity of left substantia nigra; MDRSN, mean diffusivity of right substantia nigra; MKLSN, mean kurtosis of left substantia nigra; MKRSN, mean kurtosis of right substantia nigra (adapted and reproduced with permission from Guan et al [ 102 ]).…”