title: Use of diffusion tensor imaging to identify similarities and differences between cerebellar and Parkinsonism forms of multiple system atrophy.
abstract: BACKGROUND
  We performed diffusion tensor imaging to determine if multiple system atrophy (MSA)-cerebellar (C) and MSA-Parkinsonism (P) show similar changes, as shown in pathological studies.
  
  
  METHODS
  Nineteen patients with MSA-C, 12 patients with MSA-P, 20 patients with Parkinson disease, and 20 healthy controls were evaluated with the use of voxel-based morphometry analysis of diffusion tensor imaging.
  
  
  RESULTS
  There was an increase in apparent diffusion coefficient values in the middle cerebellar peduncles and cerebellum and a decrease in fractional anisotropy in the pyramidal tract, middle cerebellar peduncles, and white matter of the cerebellum in patients with MSA-C and MSA-P compared to the controls (P < 0.001). In addition, isotropic diffusion-weighted image values were reduced in the cerebellar cortex and deep cerebellar nuclei in patients with MSA-C and increased in the basal ganglia in patients with MSA-P.
  
  
  CONCLUSIONS
  These results indicate that despite their disparate clinical manifestations, patients with MSA-C and MSA-P share similar diffusion tensor imaging features in the infratentorial region. Further, the combination of FA, ADC and iDWI images can be used to distinguish between MSA (either form) and Parkinson disease, which has potential therapeutic implications.
authors.affiliation: Department of Neurology, School of Medicine, National Yang-Ming University, #155, Sec.2, Linung St., Peitou District, 112 Taipei, Taiwan.
authors.forename: Po-Shan
authors.initials: PS
authors.lastname: Wang
authors.forename: Hsiu-Mei
authors.initials: HM
authors.lastname: Wu
authors.forename: Ching-Po
authors.initials: CP
authors.lastname: Lin
authors.forename: Bing-Wen
authors.initials: BW
authors.lastname: Soong
mesh_terms: D000368:Aged; D002526:Cerebellar Diseases / Q000473:pathology*; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000473:pathology*; D010300:Parkinson Disease / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity