title: A voxel based comparative analysis using magnetization transfer imaging and T1-weighted magnetic resonance imaging in progressive supranuclear palsy.
abstract: OBJECTIVE
  In progressive supranuclear palsy (PSP) tissue damage occurs in specific cortical and subcortical regions. Voxel based analysis using T1-weighted images depict quantitative gray matter (GM) atrophy changes. Magnetization transfer (MT) imaging depicts qualitative changes in the brain parenchyma. The purpose of our study was to investigate whether MT imaging could indicate abnormalities in PSP.
  
  
  METHODS
  A total of 10 patients with PSP (9 men and 1 woman) and 8 controls (5 men and 3 women) were studied with T1-weighted magnetic resonance imaging (MRI) and 3DMT imaging. Voxel based analysis of T1-weighted MRI was performed to investigate brain atrophy while MT was used to study qualitative abnormalities in the brain tissue. We used SPM8 to investigate group differences (with two sample t-test) using the GM and white matter (WM) segmented data.
  
  
  RESULTS
  T1-weighted imaging and MT are equally sensitive to detect changes in GM and WM in PSP. Magnetization transfer ratio images and magnetization-prepared rapid acquisition of gradient echo revealed extensive bilateral volume and qualitative changes in the orbitofrontal, prefrontal cortex and limbic lobe and sub cortical GM. The prefrontal structures involved were the rectal gyrus, medial, inferior frontal gyrus (IFG) and middle frontal gyrus (MFG). The anterior cingulate, cingulate gyrus and lingual gyrus of limbic lobe and subcortical structures such as caudate, thalamus, insula and claustrum were also involved. Cerebellar involvement mainly of anterior lobe was also noted.
  
  
  CONCLUSIONS
  The findings suggest that voxel based MT imaging permits a whole brain unbiased investigation of central nervous system structural integrity in PSP.
authors.affiliation: Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India.
authors.forename: Mangalore
authors.initials: M
authors.lastname: Sandhya
authors.affiliation: Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India.
authors.forename: Jitender
authors.initials: J
authors.lastname: Saini
authors.affiliation: Department of Neurology, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India.
authors.forename: Shaik Afsar
authors.initials: SA
authors.lastname: Pasha
authors.affiliation: Department of Neurology, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India.
authors.forename: Ravi
authors.initials: R
authors.lastname: Yadav
authors.affiliation: Department of Neurology, National Institute of Mental Health & Neurosciences, Bengaluru, Karnataka, India.
authors.forename: Pramod Kumar
authors.initials: PK
authors.lastname: Pal
keywords: Magnetization transfer ratio; progressive supranuclear palsy; progressive supranuclear palsy Parkinson subtype; progressive supranuclear palsy classic subtype; voxel based morphometry