Abstract
Background: Patients with Parkinson's disease (PD) and progressive supranuclear palsy Richardson's syndrome (PSP-RS) often show overlapping clinical features, leading to misdiagnoses. The objective of this study was to investigate the feasibility and utility of using multi-modal MRI datasets for an automatic differentiation of PD patients, PSP-RS patients, and healthy control (HC) subjects.Material and Methods: T1-weighted, T2-weighted, and diffusion-tensor (DTI) MRI datasets from 45 PD patients, 20 PSP-RS patients, and 38 HC subjects were available for this study. Using an atlas-based approach, regional values of brain morphology (T1-weighted), brain iron metabolism (T2-weighted), and microstructural integrity (DTI) were measured and employed for feature selection and subsequent classification using combinations of various established machine learning methods.Results: The optimal machine learning model using regional morphology features only achieved a classification accuracy of 65% (67/103 correct classifications) differentiating PD patients, PSP-RS patients, and HC subjects. The optimal machine learning model using only quantitative T2 values performed slightly better and achieved an accuracy of 75.7% (78/103). The optimal classifier using DTI features alone performed considerably better with 95.1% accuracy (98/103). The optimal multi-modal classifier using all features also achieved an accuracy of 95.1% but required more features and achieved a slightly lower F1-score compared to the optimal model using DTI features alone.Conclusion: Machine learning models using multi-modal MRI perform significantly better than uni-modal machine learning models using morphological parameters based on T1-weighted MRI datasets alone or brain iron metabolism markers based on T2-weighted MRI datasets alone. However, machine learnig models using regional brain microstructural integrity metrics computed from DTI datasets perform similar to the optimal multi-modal machine learning model. Thus, given the results from this study cohort, it appears that morphology and brain iron metabolism markers may not provide additional value for classification compared to using DTI metrics alone.
Highlights
The early differential diagnosis of classical Parkinson’s disease (PD) and progressive supranuclear palsy (PSP)—in particular the Richardson’s syndrome (PSP-RS)—is often limited by overlapping symptom profiles, which are not effectively captured by existing clinical scores or established diagnostic methods
45 PD, 20 progressive supranuclear palsy Richardson’s syndrome (PSP-RS), and 38 healthy control (HC) subjects presenting to the movement disorder outpatient clinic of the Neurology Department of the University Medical Center Hamburg-Eppendorf between July 2009 and September 2010 were used for this secondary, retrospective study
Surface area, and surface area to volume ratio features derived from structural T1-weighted magnetic resonance imaging (MRI) datasets resulted in a top overall accuracy of 65% differentiating PD, PSPRS, and HC subjects, respectively
Summary
The early differential diagnosis of classical Parkinson’s disease (PD) and progressive supranuclear palsy (PSP)—in particular the Richardson’s syndrome (PSP-RS)—is often limited by overlapping symptom profiles, which are not effectively captured by existing clinical scores or established diagnostic methods. Within this context, failure rates of up to 24% have been reported, even by movement disorders specialists [1]. The identification of early disease manifestations may lead to better targeted pharmaceutical therapies and enable advancements in developing more effective drug therapies in this domain. Patients with Parkinson’s disease (PD) and progressive supranuclear palsy Richardson’s syndrome (PSP-RS) often show overlapping clinical features, leading to misdiagnoses. The objective of this study was to investigate the feasibility and utility of using multi-modal MRI datasets for an automatic differentiation of PD patients, PSP-RS patients, and healthy control (HC) subjects
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