Characterization and diagnostic potential of diffusion tractography in multiple system atrophy
Characterization and diagnostic potential of diffusion tractography in multiple system atrophy
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DOI：
10.1016/j.parkreldis.2021.02.027
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发表时间：
2021-03-10
影响因子：
4.1
通讯作者：
Scherfler, Christoph
中科院分区：
文献类型：
--
作者：
Beliveau, Vincent;Krismer, Florian;Scherfler, Christoph
简介：与帕金森病（PD）相比，弥散张量成像（DTI）捕获的小脑中脚（MCP）和壳核的微结构完整性在帕金森病和小脑多系统萎缩（MSA-P，MSA-C）变体中受到不同影响。本研究应用DTI和纤维束成像，以1）表征DTI指标沿着MCP束和MSA变体中壳核的分布，2）评价结合这些指标在临床环境中鉴别诊断MSA-P与PD的有用性。研究方法：29名平均病程为2.8 ± 1.7年的MSA患者（MSA-C，n = 10; MSA-P，n = 19）、19名PD患者和27名健康对照（HC）被纳入研究。自动化纤维束成像与掩蔽程序被用来隔离MCP束。获取沿MCP束和壳核内的沿着DTI测量值，并联合用于对MSA与PD和MSA-P与PD进行分类。在事后分析中，还将壳核体积作为分类特征进行了检验。结果：与HC和PD相比，MCP和壳核内的DTI测量显示MSA变体的显著改变。使用扩散测量，MSA与PD和MSA-P与PD的分类准确率分别为91.7%和89.5%。当用标准化的壳核体积分类测量代替壳核DTI测量时，准确率分别提高到95.8%和94.7%。结论：MCP纤维束成像和壳核体积的多模态信息产生了极好的诊断准确性，以区分早期至中度晚期MSA和PD患者。
Introduction: Microstructural integrity of the middle cerebellar peduncle (MCP) and the putamen captured by diffusion-tensor imaging (DTI) is differentially affected in the parkinsonian and cerebellar variants of multiple system atrophy (MSA-P, MSA-C) compared to Parkinson's disease (PD). The current study applied DTI and tractography in order to 1) characterize the distribution of DTI metrics along the tracts of the MCP and from the putamen in MSA variants, and 2) evaluate the usefulness of combining these measures for the differential diagnosis of MSA-P against PD in the clinical setting. Methods: Twenty-nine MSA patients (MSA-C, n = 10; MSA-P, n = 19), with a mean disease duration of 2.8 +/- 1.7 years, 19 PD patients, and 27 healthy controls (HC) were included in the study. Automatized tractography with a masking procedure was employed to isolate the MCP tracts. DTI measures along the tracts of the MCP and within the putamen were acquired and jointly used to classify MSA vs. PD, and MSA-P vs. PD. Putamen volume was additionally tested as classification feature in post hoc analyses. Results: DTI measures within the MCP and putamen showed significant alterations in MSA variants compared to HC and PD. Classification accuracy for MSA vs. PD and MSA-P vs PD using diffusion measures was 91.7% and 89.5%, respectively. When replacing the putaminal DTI measure by a normalized measure of putamen volume classification accuracy improved to 95.8% and 94.7%, respectively. Conclusion: Multimodal information from MCP tractography and putamen volume yields excellent diagnostic accuracy to discriminate between early-to-moderately advanced patients with MSA and PD.