title: In vivo evaluation of white matter pathology in patients of progressive supranuclear palsy using TBSS.
abstract: BACKGROUND
  The purpose of this research is to study white matter (WM) changes in patients of progressive supranuclear palsy (PSP) using automated analysis of diffusion tensor imaging (DTI) indices.
  
  
  METHODS
  This was a prospective study comprising of 24 patients of PSP and 26 matched healthy controls. Fractional anisotropy, mean diffusivity (MD), axial diffusivity, and radial diffusivity (RD) changes were studied in the WM of the PSP patients using an automated analysis technique, tract-based spatial statistics (TBSS). Two subtypes of PSP, i.e., classic Richardson's syndrome (PSP-RS) and parkinsonian type (PSP-P), were also compared among themselves to identify relative severity of WM changes as well as identify spatial distribution of the differences. Clinicoradiological correlation was done to determine the strength of correlation between WM abnormalities identified using TBSS and clinical scores.
  
  
  RESULTS
  There were areas of significant abnormality seen in the frontoparietal cerebral WM, thalamus, midbrain tectum, superior cerebellar peduncle, and cerebellar WM. The abnormalities were more spatially widespread on MD and RD maps. Compared to PSP-P, the patients of PSP-RS had more spatial abnormalities localized to the frontal WM. There was no correlation between the observed WM changes and clinical rating scales.
  
  
  CONCLUSIONS
  The TBSS analysis showed widespread WM abnormalities in PSP patients including areas which have been shown to be involved in previous pathological studies. PSP-RS showed more severe white matter abnormality compared to the PSP-P subtype.
authors.affiliation: Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health & Neurosciences, Hosur Road, Bangalore, 560029 Karnataka, India.
authors.forename: Jitender
authors.initials: J
authors.lastname: Saini
authors.forename: Bhavani Shankara
authors.initials: BS
authors.lastname: Bagepally
authors.forename: Mangalore
authors.initials: M
authors.lastname: Sandhya
authors.forename: Shaik Afsar
authors.initials: SA
authors.lastname: Pasha
authors.forename: Ravi
authors.initials: R
authors.lastname: Yadav
authors.forename: Pramod Kumar
authors.initials: PK
authors.lastname: Pal
mesh_terms: D016880:Anisotropy; D016022:Case-Control Studies; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D011446:Prospective Studies; D013494:Supranuclear Palsy, Progressive / Q000473:pathology*