title: Differential diagnosis tool for parkinsonian syndrome using multiple structural brain measures.
abstract: Clinical differentiation of parkinsonian syndromes such as the Parkinson variant of multiple system atrophy (MSA-P) and cerebellar subtype (MSA-C) from Parkinson's disease is difficult in the early stage of the disease. To identify the correlative pattern of brain changes for differentiating parkinsonian syndromes, we applied discriminant analysis techniques by magnetic resonance imaging (MRI). T1-weighted volume data and diffusion tensor images were obtained by MRI in eighteen patients with MSA-C, 12 patients with MSA-P, 21 patients with Parkinson's disease, and 21 healthy controls. They were evaluated using voxel-based morphometry and tract-based spatial statistics, respectively. Discriminant functions derived by step wise methods resulted in correct classification rates of 0.89. When differentiating these diseases with the use of three independent variables together, the correct classification rate was the same as that obtained with step wise methods. These findings support the view that each parkinsonian syndrome has structural deviations in multiple brain areas and that a combination of structural brain measures can help to distinguish parkinsonian syndromes.
authors.affiliation: Department of Mental Disorder Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8502, Japan.
authors.forename: Miho
authors.initials: M
authors.lastname: Ota
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nakata
authors.forename: Kimiteru
authors.initials: K
authors.lastname: Ito
authors.forename: Kouhei
authors.initials: K
authors.lastname: Kamiya
authors.forename: Masafumi
authors.initials: M
authors.lastname: Ogawa
authors.forename: Miho
authors.initials: M
authors.lastname: Murata
authors.forename: Satoko
authors.initials: S
authors.lastname: Obu
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kunugi
authors.forename: Noriko
authors.initials: N
authors.lastname: Sato
mesh_terms: D000368:Aged; D001921:Brain / Q000473:pathology*; D016022:Case-Control Studies; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D003937:Diagnosis, Differential; D016002:Discriminant Analysis; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D019578:Multiple System Atrophy / Q000175:diagnosis; D010300:Parkinson Disease / Q000175:diagnosis*; D020734:Parkinsonian Disorders / Q000175:diagnosis*