Voxel‐Based Morphometry and Voxel‐Based Relaxometry in Parkinsonian Variant of Multiple System Atrophy

Tzarouchi, Loukia; Astrakas, Loukas G.; Konitsiotis, Spyridon; Tsouli, Sofia; Margariti, Persefoni; Zikou, Anastasia; Argyropoulou, Maria I.

doi:10.1111/j.1552-6569.2008.00343.x

Cited by 30 publications

(18 citation statements)

References 42 publications

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“…Voxel-based morphometry (VBM), an operator-independent automated method, can detect focal volume differences between 2 or more groups based on study-specific templates (Ashburner et al, 2000). Studies using this approach confirmed previous ROI-based volumetric studies suggesting basal ganglia, infratentorial as well as cortical volume loss in MSA patients (Minnerop et al, 2007; Moller et al, 2017; Specht et al, 2003; Tzarouchi et al, 2010). Moreover, specific longitudinal changes in MSA (early atrophy of basal ganglia followed by late cortical atrophy) have been identified with this technique (Brenneis et al, 2007).…”

Section: Brain and Cardiac Neuroimagingsupporting

confidence: 83%

Diagnosis of multiple system atrophy

Palma

Norcliffe‐Kaufmann

Kaufmann

2018

Autonomic Neuroscience

126

114

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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.

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Section: Brain and Cardiac Neuroimagingsupporting

confidence: 83%

Diagnosis of multiple system atrophy

Palma

Norcliffe‐Kaufmann

Kaufmann

2018

Autonomic Neuroscience

126

114

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“…Putaminal atrophy in MSA was not significant compared to PD in our VBM analysis, but has been detected in previous VBM studies comparing MSA to controls [26,27,28] and MSA to PD [27]. Differences in disease duration and the limited size of our study population might be reasons for this discrepancy.…”

Section: Discussioncontrasting

confidence: 48%

Diffusion Tensor Imaging in Idiopathic Parkinson's Disease and Multisystem Atrophy (Parkinsonian Type)

Cnyrim¹,

Kupsch

Ebersbach

et al. 2013

Neurodegener Dis

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Background: Differentiation between Parkinson's disease (PD) and atypical Parkinson syndromes (AP) is usually based on clinical examination, but can be challenging especially at early stages of the diseases. Diffusion tensor imaging (DTI) allows for differentiation between PD and AP with good specificity. It is a promising tool for clinical application, but has not been elaborated completely with respect to methodology and validity. Objective: In this study we evaluated differences of the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) within white brain matter between patients with PD and multisystem atrophy of the parkinsonian type (MSAp). Materials and Methods: DTI data of 9 PD and 9 MSAp patients were compared by means of a hypothesis-free whole-brain analysis algorithm (TBSS) focusing on changes within white matter. Results: We found significantly higher values of the ADC in the MSAp group in the anterior limb of the inner capsule, superior parts of the corona radiata, and lateral periputaminal white matter. Group differences in FA values were not significant. Conclusion: Changes of the ADC close to the putamen proved most consistent and seem to be promising for the ongoing clinical implementation of DTI for the differentiation of hypokinetic-rigid movement disorders.

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“…ROIs were put on the “single_subj_T1.nii” image regarded as the anatomically standard image in SPM5, in the fourth ventricle, cerebellum hemisphere; these were derived from the WFU_PickAtlas, extension program of SPM5 [28, 29]. We also put ROIs on the “FMRIB58_FA-skeleton_1 mm.nii” image, which is the anatomically standard image in FSL, in the MCP, superior cerebellar peduncle (SCP), pons, substantia nigra, superior temporal white matter region, prefrontal white matter regions, and primary motor region where previous studies showed differences among the patients with MSA-C, MSA-P, PD, and controls (Figure 1) [20, 22, 30–37]. The value of a particular tissue was extracted using the software MarsBar [38], an extension program of SPM5.…”

Section: Methodsmentioning

confidence: 99%

Differential Diagnosis Tool for Parkinsonian Syndrome Using Multiple Structural Brain Measures

Ota

Nakata

Ito

et al. 2013

Computational and Mathematical Methods in Medicine

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Clinical differentiation of parkinsonian syndromes such as the Parkinson variant of multiple system atrophy (MSA-P) and cerebellar subtype (MSA-C) from Parkinson's disease is difficult in the early stage of the disease. To identify the correlative pattern of brain changes for differentiating parkinsonian syndromes, we applied discriminant analysis techniques by magnetic resonance imaging (MRI). T1-weighted volume data and diffusion tensor images were obtained by MRI in eighteen patients with MSA-C, 12 patients with MSA-P, 21 patients with Parkinson's disease, and 21 healthy controls. They were evaluated using voxel-based morphometry and tract-based spatial statistics, respectively. Discriminant functions derived by step wise methods resulted in correct classification rates of 0.89. When differentiating these diseases with the use of three independent variables together, the correct classification rate was the same as that obtained with step wise methods. These findings support the view that each parkinsonian syndrome has structural deviations in multiple brain areas and that a combination of structural brain measures can help to distinguish parkinsonian syndromes.

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Voxel‐Based Morphometry and Voxel‐Based Relaxometry in Parkinsonian Variant of Multiple System Atrophy

Abstract: Diffuse brain atrophy, mainly in the motor circuitry is observed in MSA-P. Normalization for atrophy should always be performed in T2 measurements.

Cited by 30 publications

References 42 publications

Diagnosis of multiple system atrophy

Diagnosis of multiple system atrophy

Diffusion Tensor Imaging in Idiopathic Parkinson's Disease and Multisystem Atrophy (Parkinsonian Type)

Differential Diagnosis Tool for Parkinsonian Syndrome Using Multiple Structural Brain Measures

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