Abstract
Background. It is critical to distinguish between Parkinson's disease (PD) and scans without evidence of dopaminergic deficit (SWEDD), because the two groups are different and require different therapeutic approaches. Objective. The aim of this study was to distinguish SWEDD patients from PD patients using connectivity information derived from diffusion tensor imaging tractography. Methods. Diffusion magnetic resonance images of SWEDD (n = 37) and PD (n = 40) were obtained from a research database. Tractography, the process of obtaining neural fiber information, was performed using custom software. Group-wise differences between PD and SWEDD patients were quantified using the number of connected fibers between two regions, and correlation analyses were performed based on clinical scores. A support vector machine classifier (SVM) was applied to distinguish PD and SWEDD based on group-wise differences. Results. Four connections showed significant group-wise differences and correlated with the Unified Parkinson's Disease Rating Scale sponsored by the Movement Disorder Society. The SVM classifier attained 77.92% accuracy in distinguishing between SWEDD and PD using these identified connections. Conclusions. The connections and regions identified represent candidates for future research investigations.
Highlights
Parkinson’s disease (PD), the second most common neurodegenerative disease in the elderly, causes the loss of dopaminergic neurons in the brainstem, especially those in the substantia nigra [1]
The stacked connectivity matrices of scans without evidence of dopaminergic deficit (SWEDD) and PD groups were investigated using nonparametric permutation tests in order to identify elements that distinguished between PD and SWEDD patients
Pallidum-frontal pole, pallidumpostcentral gyrus, and putamen-precentral gyrus connections in the left hemisphere decreased in PD compared to SWEDD
Summary
Parkinson’s disease (PD), the second most common neurodegenerative disease in the elderly, causes the loss of dopaminergic neurons in the brainstem, especially those in the substantia nigra [1]. About 10% of clinically diagnosed PD patients do not lose dopaminergic neurons in the brainstem and are classified as scans without evidence of dopaminergic deficit (SWEDD) [4]. It is critical to distinguish between Parkinson’s disease (PD) and scans without evidence of dopaminergic deficit (SWEDD), because the two groups are different and require different therapeutic approaches. Group-wise differences between PD and SWEDD patients were quantified using the number of connected fibers between two regions, and correlation analyses were performed based on clinical scores. A support vector machine classifier (SVM) was applied to distinguish PD and SWEDD based on group-wise differences. Four connections showed significant group-wise differences and correlated with the Unified Parkinson’s Disease Rating Scale sponsored by the Movement Disorder Society. The connections and regions identified represent candidates for future research investigations
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