title: Patterns of brain atrophy in Parkinson's disease, progressive supranuclear palsy and multiple system atrophy.
abstract: OBJECTIVE
  Quantitative analysis of brain atrophy may be useful in differentiating Parkinson's Disease (PD) from Progressive Supranuclear Palsy (PSP) and parkinsonian variant of Multiple System Atrophy (MSA-P); the aim of this study was to identify the volumetric differences of subcortical structures in patients with PD, PSP and MSA-P using a novel and validated fully-automated whole brain segmentation method.
  
  
  METHODS
  Volumetric MRIs were obtained in 72 patients with PD, 32 patients with PSP, 15 patients with MSA-P, and in 46 control subjects. Subcortical volume was measured automatically by FreeSurfer. Multivariate analysis of covariance, adjusted for intracranial volume (ICV), sex and age, was used to explore group differences.
  
  
  RESULTS
  No volumetric differences were found between PD and controls group; otherwise the volumes of the cerebellum, the thalamus, the putamen, the pallidum, the hippocampus, and the brainstem were significantly reduced in PSP and MSA-P compared to patients with PD and control subjects. PSP and MSA-P patients only differed in thalamus volume which was smaller in PSP group (p < 0.001). Moreover, patients with PSP and MSA-P showed a ventricular system (including lateral, third and fourth ventricles) larger than that detected in PD and controls (p < 0.001).
  
  
  CONCLUSIONS
  Volumetric data obtained with automated segmentation of cerebral regions show a significant atrophy of different brain structures in parkinsonisms rather than in PD. Our study also demonstrates that the atrophy of the thalamus only occurs in PSP while the enlargement of the whole ventricular system characterizes both PSP and MSA-P.
authors.affiliation: Institute of Neurological Sciences, National Research Council, Piano-Lago, Mangone, Italy.
authors.forename: Demetrio
authors.initials: D
authors.lastname: Messina
authors.forename: Antonio
authors.initials: A
authors.lastname: Cerasa
authors.forename: Francesca
authors.initials: F
authors.lastname: Condino
authors.forename: Gennarina
authors.initials: G
authors.lastname: Arabia
authors.forename: Fabiana
authors.initials: F
authors.lastname: Novellino
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nicoletti
authors.forename: Maria
authors.initials: M
authors.lastname: Salsone
authors.forename: Maurizio
authors.initials: M
authors.lastname: Morelli
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Lanza
authors.forename: Aldo
authors.initials: A
authors.lastname: Quattrone
mesh_terms: D000368:Aged; D001284:Atrophy / Q000209:etiology; D001921:Brain / Q000473:pathology*; D001931:Brain Mapping; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000150:complications / Q000473:pathology*; D010300:Parkinson Disease / Q000150:complications / Q000473:pathology*; D018709:Statistics, Nonparametric; D013494:Supranuclear Palsy, Progressive / Q000150:complications / Q000473:pathology*