title: Diffusion tensor MRI contributes to differentiate Richardson's syndrome from PSP-parkinsonism.
abstract: This study investigated the regional distribution of white matter (WM) damage in Richardson's syndrome (PSP-RS) and progressive supranuclear palsy-Parkinsonism (PSP-P) using diffusion tensor (DT) magnetic resonance imaging (MRI). The DT MRI classificatory ability in diagnosing progressive supranuclear palsy (PSP) syndromes, when used in combination with infratentorial volumetry, was also quantified. In 37 PSP (21 PSP-RS, 16 PSP-P) and 42 controls, the program Tract-Based Spatial Statistics (TBSS; www.fmrib.ox.ac.uk/fsl/tbss) was applied. DT MRI metrics were derived from supratentorial, thalamic, and infratentorial tracts. The magnetic resonance parkinsonism index (MRPI) was calculated. All PSP harbored diffusivity abnormalities in the corpus callosum, frontoparietal, and frontotemporo-occipital tracts. Infratentorial WM and thalamic radiations were severely affected in PSP-RS and relatively spared in PSP-P. When MRPI and DT MRI measures were combined, the discriminatory power increased for each comparison. Distinct patterns of WM alterations occur in PSP-RS and PSP-P. Adding DT MRI measures to MRPI improves the diagnostic accuracy in differentiating each PSP syndrome from healthy individuals and each other.
authors.affiliation: Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Agosta
authors.forename: Michela
authors.initials: M
authors.lastname: Pievani
authors.forename: Marina
authors.initials: M
authors.lastname: Svetel
authors.forename: Milica
authors.initials: M
authors.lastname: Ječmenica Lukić
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Copetti
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Tomić
authors.forename: Antonio
authors.initials: A
authors.lastname: Scarale
authors.forename: Giulia
authors.initials: G
authors.lastname: Longoni
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Comi
authors.forename: Vladimir S
authors.initials: VS
authors.lastname: Kostić
authors.forename: Massimo
authors.initials: M
authors.lastname: Filippi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy / Q000473:pathology; D001921:Brain / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D056784:Leukoencephalopathies / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D010300:Parkinson Disease / Q000150:complications; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013494:Supranuclear Palsy, Progressive / Q000150:complications / Q000175:diagnosis*