Diffusion tensor imaging of Parkinson's disease, atypical parkinsonism, and essential tremor

Prodoehl, Janey; Li, Hong; Planetta, Peggy J.; Goetz, Christopher G.; Shannon, Kathleen M.; Tangonan, Ruth; Comella, Cynthia L.; Simuni, Tanya; Zhou, Xiaohong Joe; Leurgans, Sue E.; Corcos, Daniel M.; Vaillancourt, David E.

doi:10.1002/mds.25491

Cited by 92 publications

(85 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These results are similar to recent neuroimaging studies reporting comparable sensitivity and specificity in metabolic pattern analysis or Diffusion Tensor Imaging in the differential diagnosis of parkinsonism [4,35]. In addition, our classification results between PD and APS seem to be superior to very recently introduced breath analysis, which showed 88 % sensitivity and 88 % accuracy [36].…”

Section: Discussionsupporting

confidence: 90%

“…In addition, our classification results between PD and APS seem to be superior to very recently introduced breath analysis, which showed 88 % sensitivity and 88 % accuracy [36]. However, it is noteworthy to point out that our speechbased classification between PSP and MSA provided only 74 % sensitivity and 81 % specificity, whilst previous neuroimaging studies have reported 90 % sensitivity and 100 % specificity [4,35].…”

Section: Discussioncontrasting

confidence: 49%

See 1 more Smart Citation

Speech disorders reflect differing pathophysiology in Parkinson’s disease, progressive supranuclear palsy and multiple system atrophy

et al. 2015

View full text Add to dashboard Cite

Although speech disorder is frequently an early and prominent clinical feature of Parkinson's disease (PD) as well as atypical parkinsonian syndromes (APS) such as progressive supranuclear palsy (PSP) and multiple system atrophy (MSA), there is a lack of objective and quantitative evidence to verify whether any specific speech characteristics allow differentiation between PD, PSP and MSA. Speech samples were acquired from 77 subjects including 15 PD, 12 PSP, 13 MSA and 37 healthy controls. The accurate differential diagnosis of dysarthria subtypes was based on the quantitative acoustic analysis of 16 speech dimensions. Dysarthria was uniformly present in all parkinsonian patients but was more severe in PSP and MSA than in PD. Whilst PD speakers manifested pure hypokinetic dysarthria, ataxic components were more affected in MSA whilst PSP subjects demonstrated severe deficits in hypokinetic and spastic elements of dysarthria. Dysarthria in PSP was dominated by increased dysfluency, decreased slow rate, inappropriate silences, deficits in vowel articulation and harsh voice quality whereas MSA by pitch fluctuations, excess intensity variations, prolonged phonemes, vocal tremor and strained-strangled voice quality. Objective speech measurements were able to discriminate between APS and PD with 95% accuracy and between PSP and MSA with 75% accuracy. Dysarthria severity in APS was related to overall disease severity (r = 0.54, p = 0.006). Dysarthria with various combinations of hypokinetic, spastic and ataxic components reflects differing pathophysiology in PD, PSP and MSA. Thus, motor speech examination may provide useful information in the evaluation of these diseases with similar manifestations.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 49%

Speech disorders reflect differing pathophysiology in Parkinson’s disease, progressive supranuclear palsy and multiple system atrophy

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Further, free-water elevation was more pronounced in PSP than PD and MSA. This pattern of results extends a previous single-tensor model analysis at a single-site 22 . PD and MSA free-water values were also greater than healthy controls.…”

Section: Discussionsupporting

confidence: 87%

“…Previous reports have shown that putaminal MD U can be useful to distinguish the parkinsonian variant of MSA from PD but not from PSP 23 . Diffusivity changes of the middle cerebellar peduncle, however, may provide additional information 10,22 . Our findings of changes in the posterior nigra are in line with pathological studies that report degeneration in the ventro-lateral tier of the substantia nigra in patients with degenerative parkinsonism 1 .…”

Section: Discussionmentioning

confidence: 99%

Free water improves detection of changes in the substantia nigra in parkinsonism: A multisite study

et al. 2017

Self Cite

View full text Add to dashboard Cite

Background Imaging markers that are sensitive to parkinsonism across multiple sites are critically needed for clinical trials. Objective To evaluate changes in the substantia nigra using single- and bi-tensor models of diffusion magnetic resonance imaging in PD, MSA, and PSP. Methods The study cohort (N=425) included 107 healthy controls, 184 PD, 63 MSA, and 71 PSP patients from 3 movement disorder centers. Bi-tensor free-water, free-water corrected fractional anisotropy, free-water corrected mean diffusivity, single-tensor fractional anisotropy and single-tensor mean diffusivity were computed for anterior and posterior substantia nigra. Correlations were computed between diffusion MRI measures and clinical measures. Results In the posterior substantia nigra, free-water was greater for PSP than MSA, PD, and controls. PD and MSA both had greater free-water than controls. Free-water corrected fractional anisotropy values were greater for PSP when compared to controls and PD. PSP and MSA single-tensor mean diffusivity values were greater than controls and single-tensor fractional anisotropy values were lower for PSP than healthy controls. The parkinsonism effect size for free-water in the posterior substantia nigra was 0.145 and for single-tensor mean diffusivity was 0.072. The direction of correlations between single-tensor mean diffusivity and free-water values and clinical scores were similar at each site. Conclusions Free-water values in the posterior substantia nigra provide consistent pattern of findings across PD, MSA and PSP in a large cohort across three sites. Free-water in the posterior substantia nigra relates to clinical measures of motor and cognitive symptoms in a large cohort of parkinsonism.

show abstract

“…Interestingly, a prospective study showed progressive abnormalities of the diffusivity of the putamen over time, thus allowing the possibility of using DWI imaging as a marker of disease progression and an outcome measure in clinical trials for MSA (Pellecchia et al, 2011). Diffusion tensor imaging (DTI), a similar technique to DWI which analyzes the three-dimensional shape of the diffusion and produces 3-D neural tract images (Huisman, 2010), is being increasingly used to distinguish MSA from PD and PSP (Du et al, 2017; Ofori et al, 2017; Planetta et al, 2016; Prodoehl et al, 2013; Worker et al, 2014). …”

Section: Brain and Cardiac Neuroimagingmentioning

confidence: 99%

Diagnosis of multiple system atrophy

Palma

Norcliffe‐Kaufmann

Kaufmann

2018

Autonomic Neuroscience

126

114

View full text Add to dashboard Cite

Multiple system atrophy (MSA) may be difficult to distinguish clinically from other disorders, particularly in the early stages of the disease. An autonomic-only presentation can be indistinguishable from pure autonomic failure. Patients presenting with parkinsonism may be misdiagnosed as having Parkinson disease. Patients presenting with the cerebellar phenotype of MSA can mimic other adult-onset ataxias due to alcohol, chemotherapeutic agents, lead, lithium, and toluene, or vitamin E deficiency, as well as paraneoplastic, autoimmune, or genetic ataxias. A careful medical history and meticulous neurological examination remain the cornerstone for the accurate diagnosis of MSA. Ancillary investigations are helpful to support the diagnosis, rule out potential mimics, and define therapeutic strategies. This review summarizes diagnostic investigations useful in the differential diagnosis of patients with suspected MSA. Currently used techniques include structural and functional brain imaging, cardiac sympathetic imaging, cardiovascular autonomic testing, olfactory testing, sleep study, urological evaluation, and dysphagia and cognitive assessments. Despite advances in the diagnostic tools for MSA in recent years and the availability of consensus criteria for clinical diagnosis, the diagnostic accuracy of MSA remains sub-optimal. As other diagnostic tools emerge, including skin biopsy, retinal biomarkers, blood and cerebrospinal fluid biomarkers, and advanced genetic testing, a more accurate and earlier recognition of MSA should be possible, even in the prodromal stages. This has important implications as misdiagnosis can result in inappropriate treatment, patient and family distress, and erroneous eligibility for clinical trials of disease-modifying drugs.

show abstract

Diffusion tensor imaging of Parkinson's disease, atypical parkinsonism, and essential tremor

Cited by 92 publications

References 43 publications

Speech disorders reflect differing pathophysiology in Parkinson’s disease, progressive supranuclear palsy and multiple system atrophy

Speech disorders reflect differing pathophysiology in Parkinson’s disease, progressive supranuclear palsy and multiple system atrophy

Free water improves detection of changes in the substantia nigra in parkinsonism: A multisite study

Diagnosis of multiple system atrophy

Contact Info

Product

Resources

About