Loss of substantia nigra hyperintensity on 7 Tesla MRI of Parkinson's disease, multiple system atrophy, and progressive supranuclear palsy

Kim, Jong Min; Jeong, Hye Jin; Bae, Yun Jung; Park, Jong-Wan; Kim, Eun‐Hee; Kang, Seo Young; Oh, Eung Seok; Kim, Kyeong Joon; Jeon, Beomseok; Kim, Sang Eun; Cho, Zang Hee; Kim, Young Bo

doi:10.1016/j.parkreldis.2016.01.023

Cited by 67 publications

(82 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In PD patients, the increased iron content in nigrosome‐1 leads to the loss of this dorsolateral hyperintensity, as shown by three recent 7T MRI studies (Fig. ) . Subsequent studies using 3T MRI have also been able to replicate this finding in most PD patients (refer to Table for list of studies) .…”

Section: Nigrosome Imagingmentioning

confidence: 70%

Nigrosome Imaging and Neuromelanin Sensitive MRI in Diagnostic Evaluation of Parkinsonism

Pavese

Tai

2018

Movement Disord Clin Pract

View full text Add to dashboard Cite

Background Recent developments in magnetic resonance imaging (MRI) techniques have offered new research opportunities to visualize in vivo substantia nigra pathology in Parkinson's disease (PD). This paper summarizes the main findings of nigrosome imaging and neuromelanin sensitive MRI studies in patients with PD and other parkinsonisms. Methods The PubMed database was searched from 2005 to 2017 using the following keywords: Parkinson's disease and parkinsonism, in combination with MRI, nigrosome, neuromelanin, and iron. Only publications in English were included. Results Nigrosome or dorsal nigral hyperintensity abnormalities are studied using T2* and susceptibility weighted imaging MRI sequences in most studies, whereas Neuromelanin imaging is usually performed using T1‐weighted fast spin echo sequence. Nigrosome abnormalities have been consistently demonstrated in PD patients, and nigrosome imaging has high sensitivity and specificity in distinguishing PD from healthy controls, though it is unable to reliably separate PD from atypical parkinsonisms. Reduced neuromelanin‐related signals and/or volume loss in neuromelanin containing structures have been found in PD patients, and neuromelanin sensitive MRI imaging can also discriminate PD patients from healthy controls with high accuracy, though there is a degree of heterogeneity in the imaging findings. Preliminary findings suggested that longitudinal change of neuromelanin signal could be detected in PD, raising the possibility of using it as a marker of disease progression. Conclusion Nigrosome imaging and neuromelanin sensitive MRI are promising tools to study nigral pathology and to improve the diagnosis of PD. However, further studies are required to standardize analysis approaches, confirm longitudinal changes, and assess their generalizability.

show abstract

Section: Nigrosome Imagingmentioning

confidence: 70%

Nigrosome Imaging and Neuromelanin Sensitive MRI in Diagnostic Evaluation of Parkinsonism

Pavese

Tai

2018

Movement Disord Clin Pract

View full text Add to dashboard Cite

show abstract

“…Routine MR imaging has very low specificity to distinguish MSA from other atypical parkinsonian syndromes (Schrag et al, 2000; Yekhlef et al, 2003). Increasing use of 7-Telsa MR imaging, and better sequences to discriminate the brainstem anatomy, should enable the development of more sensitive and specific diagnostic algorithms (Hoch et al, 2016; Kim et al, 2016). …”

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

“…Because nigrosome-1 is a histological concept, which refers to a calbindin-negative subregion in the SNc, the descriptive terms ‘Dorsolateral Nigral Hyperintensity’ (DNH) or ‘Nigral hyperintensity’ have been introduced (Reiter et al 2015; Bae et al 2016). Overall, in the studies published so far, loss of DNH had a high sensitivity (79–100%) and specificity (85–100%) to separate PD from controls (Schwarz et al 2014; Reiter et al 2015; Bae et al 2016; Kim et al 2016; Sung et al 2016). Moreover, a recent meta-analysis including 364 patients with PD and 331 controls from 10 studies showed an overall sensitivity and specificity of the absence of DNH for PD vs. controls of 98 and 95% and of 95 and 94% when including studies performed at 3.0 T only (Mahlknecht et al 2017).…”

Section: Diagnosis Of Pdmentioning

confidence: 99%

“…This meta-analysis demonstrates a potential value in differentiating PD from uncertain movement disorders such as DIP, ET and dystonic tremor. Indeed, a recent study reported that patients with DIP could be discriminated from those with PD with high sensitivity and specificity (Sung et al 2016), while loss of DNH seems not to discriminate between PD and atypical parkinsonism due to MSA and PSP (Reiter et al 2015; Bae et al 2016; Kim et al 2016). …”

Section: Diagnosis Of Pdmentioning

confidence: 99%

Magnetic resonance imaging for the diagnosis of Parkinson’s disease

et al. 2017

View full text Add to dashboard Cite

The differential diagnosis of parkinsonian syndromes is considered one of the most challenging in neurology and error rates in the clinical diagnosis can be high even at specialized centres. Despite several limitations, magnetic resonance imaging (MRI) has undoubtedly enhanced the diagnostic accuracy in the differential diagnosis of neurodegenerative parkinsonism over the last three decades. This review aims to summarize research findings regarding the value of the different MRI techniques, including advanced sequences at high- and ultra-high-field MRI and modern image analysis algorithms, in the diagnostic work-up of Parkinson’s disease. This includes not only the exclusion of alternative diagnoses for Parkinson’s disease such as symptomatic parkinsonism and atypical parkinsonism, but also the diagnosis of early, new onset, and even prodromal Parkinson’s disease.

show abstract

Loss of substantia nigra hyperintensity on 7 Tesla MRI of Parkinson's disease, multiple system atrophy, and progressive supranuclear palsy

Cited by 67 publications

References 29 publications

Nigrosome Imaging and Neuromelanin Sensitive MRI in Diagnostic Evaluation of Parkinsonism

Nigrosome Imaging and Neuromelanin Sensitive MRI in Diagnostic Evaluation of Parkinsonism

Diagnosis of multiple system atrophy

Magnetic resonance imaging for the diagnosis of Parkinson’s disease

Contact Info

Product

Resources

About