title: Diffusion tensor imaging of Parkinson's disease, atypical parkinsonism, and essential tremor.
abstract: Diffusion tensor imaging could be useful in characterizing movement disorders because it noninvasively examines multiple brain regions simultaneously. We report a multitarget imaging approach focused on the basal ganglia and cerebellum in Parkinson's disease, parkinsonian variant of multiple system atrophy, progressive supranuclear palsy, and essential tremor and in healthy controls. Seventy-two subjects were studied with a diffusion tensor imaging protocol at 3 Tesla. Receiver operating characteristic analysis was performed to directly compare groups. Sensitivity and specificity values were quantified for control versus movement disorder (92% sensitivity, 88% specificity), control versus parkinsonism (93% sensitivity, 91% specificity), Parkinson's disease versus atypical parkinsonism (90% sensitivity, 100% specificity), Parkinson's disease versus multiple system atrophy (94% sensitivity, 100% specificity), Parkinson's disease versus progressive supranuclear palsy (87% sensitivity, 100% specificity), multiple system atrophy versus progressive supranuclear palsy (90% sensitivity, 100% specificity), and Parkinson's disease versus essential tremor (92% sensitivity, 87% specificity). The brain targets varied for each comparison, but the substantia nigra, putamen, caudate, and middle cerebellar peduncle were the most frequently selected brain regions across classifications. These results indicate that using diffusion tensor imaging of the basal ganglia and cerebellum accurately classifies subjects diagnosed with Parkinson's disease, atypical parkinsonism, and essential tremor and clearly distinguishes them from control subjects.
authors.affiliation: Physical Therapy Program, Midwestern University, Downers Grove, Illinois, USA.
authors.forename: Janey
authors.initials: J
authors.lastname: Prodoehl
authors.forename: Hong
authors.initials: H
authors.lastname: Li
authors.forename: Peggy J
authors.initials: PJ
authors.lastname: Planetta
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Goetz
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Shannon
authors.forename: Ruth
authors.initials: R
authors.lastname: Tangonan
authors.forename: Cynthia L
authors.initials: CL
authors.lastname: Comella
authors.forename: Tanya
authors.initials: T
authors.lastname: Simuni
authors.forename: Xiaohong Joe
authors.initials: XJ
authors.lastname: Zhou
authors.forename: Sue
authors.initials: S
authors.lastname: Leurgans
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Corcos
authors.forename: David E
authors.initials: DE
authors.lastname: Vaillancourt
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D016880:Anisotropy; D001479:Basal Ganglia / Q000473:pathology*; D002531:Cerebellum / Q000473:pathology*; D056324:Diffusion Tensor Imaging; D020329:Essential Tremor / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000175:diagnosis*; D010300:Parkinson Disease / Q000175:diagnosis*; D012372:ROC Curve; D013494:Supranuclear Palsy, Progressive / Q000175:diagnosis*
keywords: DTI; basal ganglia; cerebellum; essential tremor; parkinsonism