Diagnostic Potential of Multimodal MRI Markers in Atypical Parkinsonian Disorders
Diagnostic Potential of Multimodal MRI Markers in Atypical Parkinsonian Disorders
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DOI：
10.3233/jpd-181568
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发表时间：
2019-01-01
影响因子：
5.2
通讯作者：
Scherfler, Christoph
中科院分区：
文献类型：
--
作者：
Seki, Morinobu;Seppi, Klaus;Scherfler, Christoph
背景：多模态MRI方法对进行性核上性麻痹（PSP）、帕金森氏变异型多系统萎缩（MSA-P）和帕金森氏病（PD）的诊断潜力尚未得到很好的研究。目的：分析PSP、MSA-P和PD患者的铁浓度（R2*）、显微结构完整性（平均扩散率、MD和分数各向异性、FA）和体积，以识别疾病特异性神经退行性模式并评估专用MRI的诊断准确性。方法：将18例PSP和16例MSA-P患者的3T MRI与16例年龄、病程匹配的PD患者和21例健康对照进行比较。应用统计参数映射（SPM）客观识别全脑局灶性MRI变化。通过主成分分析（PCA）对显著性和多个比较校正的SPM聚类进行降维后，采用逐步的受试者工作特征曲线分析（ROC）来确定多模态MRI参数的诊断潜力。结果：主成分分析显示两个成分涉及多个区域从SPM分析确定。第一部分主要由丘脑的平均MD值和齿状丘脑束和胼胝体的平均MD和FA值组成。第二部分主要由小脑中脚的MD和FA平均值组成。ROC分析显示92%的PSP患者能正确区分MSA-P和PD， 80%的MSA-P患者能与PD区分。结论：多模态MRI提高了PSP和MSA-P的疾病特异性神经退行性模式的检测，并突出了其提高非典型帕金森病诊断准确性的潜力。
Background: The diagnostic potential of multimodal MRI approaches to discriminate among progressive supranuclear palsy (PSP), Parkinson variant of multiple system atrophy (MSA-P) and Parkinson's disease (PD) has not been well investigated.Objective: To identify disease-specific neurodegenerative patterns and evaluate the diagnostic accuracy of dedicated MRI, iron concentration (R2*), microstructural integrity (mean diffusivity; MD and fractional anisotropy; FA) as well as volumes were analyzed in patients with PSP, MSA-P and PD.Methods: 3T MRI of 18 PSP and 16 MSA-P patients were compared with 16 PD patients matched for age and disease duration as well as 21 healthy controls. Statistical parametric mapping (SPM) was applied to objectively identify focal MRI changes throughout the whole-brain. Following dimensionality reduction of significant and multiple comparison-corrected SPM clusters through principal component analysis (PCA), stepwise receiver-operating characteristic curve analysis (ROC) was applied to determine the diagnostic potential of multimodal MRI parameters.Results: PCA revealed two components involving multiple regions identified from SPM analysis. The first component was primarily composed of the mean MD value of the thalamus and the mean MD and FA values of the dentatorubrothalamic tract and the corpus callosum. The second component mainly consisted of mean MD and FA values of the middle cerebellar peduncle. ROC analysis showed 92% of PSP patients were differentiated correctly from MSA-P and PD and 80% of MSA-P patients could be distinguished from PD.Conclusion: Multimodal MRI improved the detection of disease-specific neurodegenerative patterns in PSP and MSA-P and highlights its potential to improve the diagnostic accuracy of atypical parkinsonian disorders.