title: Putaminal volume and diffusion in early familial Creutzfeldt-Jakob disease.
abstract: BACKGROUND
  The putamen is centrally implicated in the pathophysiology of Creutzfeldt-Jakob Disease (CJD). To our knowledge, its volume has never been measured in this disease. We investigated whether gross putaminal atrophy can be detected by MRI in early stages, when the diffusion is already reduced.
  
  
  METHODS
  Twelve familial CJD patients with the E200K mutation and 22 healthy controls underwent structural and diffusion MRI scans. The putamen was identified in anatomical scans by two methods: manual tracing by a blinded investigator, and automatic parcellation by a computerized segmentation procedure (FSL FIRST). For each method, volume and mean Apparent Diffusion Coefficient (ADC) were calculated.
  
  
  RESULTS
  ADC was significantly lower in CJD patients (697+/-64 microm(2)/s vs. 750+/-31 microm(2)/s, p<0.005), as expected, but the volume was not reduced. The computerized FIRST delineation yielded comparable ADC values to the manual method, but computerized volumes were smaller than manual tracing values.
  
  
  CONCLUSIONS
  We conclude that significant diffusion reduction in the putamen can be detected by delineating the structure manually or with a computerized algorithm. Our findings confirm and extend previous voxel-based and observational studies. Putaminal volume was not reduced in our early-stage patients, thus confirming that diffusion abnormalities precede detectible atrophy in this structure.
authors.affiliation: Department of Psychiatry, Mount Sinai School of Medicine, P.O. Box 1230, One Gustave Levy Place, New York, NY 10029, USA.
authors.forename: Ilana
authors.initials: I
authors.lastname: Seror
authors.forename: Hedok
authors.initials: H
authors.lastname: Lee
authors.forename: Oren S
authors.initials: OS
authors.lastname: Cohen
authors.forename: Chen
authors.initials: C
authors.lastname: Hoffmann
authors.forename: Isak
authors.initials: I
authors.lastname: Prohovnik
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D007562:Creutzfeldt-Jakob Syndrome / Q000235:genetics / Q000473:pathology*; D003430:Cross-Sectional Studies; D004058:Diffusion; D018450:Disease Progression; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011699:Putamen / Q000473:pathology*