Abstract
BackgroundBased upon the acquainted loss of dopaminergic neurons in the substantia nigra in Parkinson’s disease (PD), we hypothesised changes in magnetic resonance imaging signal intensities of the basal ganglia to be useful as an additional technical tool in the diagnostic work-up.MethodsRegion-of-interest analyses (substantia nigra and globus pallidus internus) of T2-weighted scans were performed in seventy subjects with PD, 170 age- and gender-matched controls and 38 patients with an atypical form of neurodegenerative Parkinsonian syndrome (N = 11 multisystem atrophy, N = 22 progressive supranuclear palsy, N = 5 corticobasal syndrome).ResultsIn patients with PD, significant changes in signal intensities within the substantia nigra were observed compared to controls at p < 0.001. For the globus pallidus internus, signal alterations in PD and progressive supranuclear palsy were found to be significant (p < 0.001) if compared to controls. Furthermore, signal changes of substantia nigra correlated with signal intensities of globus pallidus internus in the ipsilateral hemisphere in both groups. Sensitivity was 86% and specificity was 90% for the combined analysis of substantia nigra and globus pallidus internus in the complete patient sample versus controls.ConclusionsSignal alterations of substantia nigra and globus pallidus internus in routine magnetic resonance imaging were useful to distinguish patients with PD from controls. In addition, signal changes in globus pallidus internus could be used to differentiate progressive supranuclear palsy patients from controls. These analyses have the potential to serve as an additional non-invasive technical tool to support the individual differential diagnosis of PD.
Highlights
Based upon the acquainted loss of dopaminergic neurons in the substantia nigra in Parkinson’s disease (PD), we hypothesised changes in magnetic resonance imaging signal intensities of the basal ganglia to be useful as an additional technical tool in the diagnostic work-up
We performed an magnetic resonance imaging (MRI)-based study in PD on the basis of the following conceptual assumptions and hypotheses: (i) signal alterations in MRI have to be investigated in routine diagnostics to be available and broadly applicable, (ii) we suspected signal changes to be visible in substantia nigra (SN) as well as the corresponding globus pallidus internus (GPI) [13], (iii) MRI signal intensities of those regions should be able to differentiate at least PD from control subjects (CON) and possibly from atypical Parkinsonian syndroms in order to be useful as an additional technical tool in the diagnostic workup
No significant differences could be found for multisystem atrophy (MSA) and CBS compared with CON for either GPI and SN in both hemispheres
Summary
Based upon the acquainted loss of dopaminergic neurons in the substantia nigra in Parkinson’s disease (PD), we hypothesised changes in magnetic resonance imaging signal intensities of the basal ganglia to be useful as an additional technical tool in the diagnostic work-up. Non-motor symptoms are increasingly used for the clinical diagnosis, including hyposmia, sleep disturbances, behavioral/emotional dysfunction, dysautonomia, depressive symptoms, and chronic pain [5] Since their sensitivity and specificity cannot be determined yet, it would be beneficial to add further technical tools that might support the clinically suspected diagnoses. Several attempts were performed to explore PD-associated brain alterations via MRI like diffusion tensor imaging, and some of those studies revealed promising results with a regional decrease in fractional anisotropy in the SN of PD patients compared with control persons [9,10,11,12] Those advanced MRI-based methods are not applicable in routine diagnostic assessments yet as specific data acquisition and time-consuming post-processing procedures are still essential for evaluation of these approaches
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
