title: Differentiation of typical and atypical Parkinson syndromes by quantitative MR imaging.
abstract: OBJECTIVE
  The differential diagnosis of Parkinson syndromes remains a major challenge. Quantitative MR imaging can aid in this classification, but it is unclear which of the proposed techniques is best suited for this task. We, therefore, conducted a head-to-head study with different quantitative MR imaging measurements in patients with IPS, MSA-type Parkinson, PSP, and healthy elderly controls.
  
  
  METHODS
  Thirty-one patients and 13 controls underwent a comprehensive quantitative MR imaging protocol including R2*-, R2- and R1-mapping, magnetization transfer, and DTI with manual region-of-interest measurements in basal ganglia regions. Group differences were assessed with a post hoc ANOVA with a Bonferroni error correction and an ROC.
  
  
  RESULTS
  The best separation of MSA from IPS in patients and controls could be achieved with R2*-mapping in the PU, with an ROC AUC of ≤0.96, resulting in a sensitivity of 77.8% (with a specificity 100%). MD was increased in patients with PSP compared with controls and to a lesser extent compared with those with IPS and MSA in the SN.
  
  
  CONCLUSIONS
  Among the applied quantitative MR imaging methods, R2*-mapping seems to have the best predictive power to separate patients with MSA from those with IPS, and DTI for identifying PSP.
authors: Department of Clinical Neurophysiology, Georg-August University Gottingen, Gottingen, Germany. nfocke@uni-goettingen.de
authors: N K
authors: NK
authors: Focke
authors: G
authors: G
authors: Helms
authors: P M
authors: PM
authors: Pantel
authors: S
authors: S
authors: Scheewe
authors: M
authors: M
authors: Knauth
authors: C G
authors: CG
authors: Bachmann
authors: J
authors: J
authors: Ebentheuer
authors: P
authors: P
authors: Dechent
authors: W
authors: W
authors: Paulus
authors: C
authors: C
authors: Trenkwalder
mesh_terms: D000368:Aged; D000465:Algorithms; D001921:Brain / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D020734:Parkinsonian Disorders / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity