title: Trace of diffusion tensor differentiates the Parkinson variant of multiple system atrophy and Parkinson's disease.
abstract: We have recently shown that diffusion-weighted magnetic resonance (MR) imaging (DWI) discriminates patients with the Parkinson variant of multiple system atrophy (MSA-P) from those with Parkinson's disease (PD) by regional apparent diffusion coefficients (rADC) in the putamen. Because rADCs measured in one direction may underestimate diffusion-related pathologic processes, we investigated the diffusivity in different brain areas by trace of diffusion tensor (Trace(D)) in a new cohort of patients with MSA-P and PD. We studied 11 MSA-P, 17 PD patients, and 10 healthy volunteers matched for age and disease duration. Regional ADCs in three orthogonal directions and Trace(D) values were determined in selected brain regions including the basal ganglia, gray matter, white matter, substantia nigra, and pons. MSA-P patients had significantly higher putaminal and pallidal rTrace(D) values as well as rADCs in y- and z-direction than both PD patients and healthy volunteers. Moreover, putaminal Trace(D) discriminated completely MSA-P from both PD and healthy volunteers. The rADCs in the y- and z-direction provided a complete or near complete separation. In conclusion, our study confirms the results of previous studies of our group that patients with MSA-P show an increased putaminal diffusivity due to neuronal loss and gliosis. Because rADCs in one direction are dependent on the slice orientation relative to the directions of fiber tracts, Trace(D) imaging appears to be more accurate in the separation of MSA-P from PD.
authors.affiliation: Department of Radiology, University of Innsbruck, Austria. michael.schocke@uibk.ac.at
authors.forename: Michael F H
authors.initials: MF
authors.lastname: Schocke
authors.forename: Klaus
authors.initials: K
authors.lastname: Seppi
authors.forename: Regina
authors.initials: R
authors.lastname: Esterhammer
authors.forename: Christian
authors.initials: C
authors.lastname: Kremser
authors.forename: Katherina J
authors.initials: KJ
authors.lastname: Mair
authors.forename: Benedikt V
authors.initials: BV
authors.lastname: Czermak
authors.forename: Werner
authors.initials: W
authors.lastname: Jaschke
authors.forename: Werner
authors.initials: W
authors.lastname: Poewe
authors.forename: Gregor K
authors.initials: GK
authors.lastname: Wenning
mesh_terms: D000368:Aged; D001479:Basal Ganglia / Q000473:pathology; D001921:Brain / Q000473:pathology*; D016923:Cell Death / Q000502:physiology; D015331:Cohort Studies; D038524:Diffusion Magnetic Resonance Imaging; D004292:Dominance, Cerebral / Q000502:physiology; D005260:Female; D005911:Gliosis / Q000175:diagnosis; D005917:Globus Pallidus / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000175:diagnosis*; D009474:Neurons / Q000473:pathology; D010300:Parkinson Disease / Q000175:diagnosis*; D011149:Pons / Q000473:pathology; D011699:Putamen / Q000473:pathology; D012016:Reference Values; D015203:Reproducibility of Results; D013378:Substantia Nigra / Q000473:pathology