title: Supratentorial and infratentorial damage in spinocerebellar ataxia 2: a diffusion-weighted MRI study.
abstract: Spinocerebellar ataxia type 2 (SCA2) is an autosomal-dominant degenerative disorder that is neuropathologically characterized primarily by infratentorial damage, although less severe supratentorial involvement may contribute to the clinical manifestation. Diffusion-weighted imaging (DWI)-Magnetic Resonance Imaging (MRI) studies of SCA2 have enabled in vivo quantification of neurodegeneration in infratentorial regions, whereas supratentorial regions have been explored less thoroughly. We measured microstructural changes in both infratentorial and supratentorial regions in 13 SCA2 patients (9 men, 4 women; mean age, 50 ± 12 years) and 15 controls (10 men, 5 women; mean age, 49 ± 14 years) using DWI-MRI and correlated the DWI changes with disease severity and duration. Disease severity was evaluated using the International Cooperative Ataxia Rating Scale and the Inherited Ataxia Clinical Rating Scale. Cerebral diffusion trace ( D¯) values were generated, and regions of interest (ROIs) and voxel-based analysis with Statistical Parametric Mapping (SPM) were used for data analysis. In SCA2 patients, ROI analysis and SPM confirmed significant increases in D¯ values in the pons, cerebellar white matter (CWM) and middle cerebellar peduncles. Moreover, SPM analysis revealed increased D¯ values in the right thalamus, bilateral temporal cortex/white matter, and motor cortex/pyramidal tract regions. Increased diffusivity in the frontal white matter (FWM) and the CWM was significantly correlated with ataxia severity. DWI-MRI revealed that both infratentorial and supratentorial microstructural changes may characterize SCA2 patients in the course of the disease and might contribute to the severity of the symptoms.
authors.affiliation: Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Salvatore
authors.forename: Enrico
authors.initials: E
authors.lastname: Tedeschi
authors.forename: Carmine
authors.initials: C
authors.lastname: Mollica
authors.forename: Caterina
authors.initials: C
authors.lastname: Vicidomini
authors.forename: Andrea
authors.initials: A
authors.lastname: Varrone
authors.forename: Anna Rita Daniela
authors.initials: AR
authors.lastname: Coda
authors.forename: Arturo
authors.initials: A
authors.lastname: Brunetti
authors.forename: Marco
authors.initials: M
authors.lastname: Salvatore
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Michele
authors.forename: Alessandro
authors.initials: A
authors.lastname: Filla
authors.forename: Sabina
authors.initials: S
authors.lastname: Pappatà
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002531:Cerebellum / Q000473:pathology*; D002540:Cerebral Cortex / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D004388:Dura Mater / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D020754:Spinocerebellar Ataxias / Q000175:diagnosis*
keywords: MRI; SCA2; diffusion-weighted imaging; neurodegeneration; spinocerebellar ataxia