title: Diffusion tensor imaging of Parkinson's disease, multiple system atrophy and progressive supranuclear palsy: a tract-based spatial statistics study.
abstract: Although often clinically indistinguishable in the early stages, Parkinson's disease (PD), Multiple System Atrophy (MSA) and Progressive Supranuclear Palsy (PSP) have distinct neuropathological changes. The aim of the current study was to identify white matter tract neurodegeneration characteristic of each of the three syndromes. Tract-based spatial statistics (TBSS) was used to perform a whole-brain automated analysis of diffusion tensor imaging (DTI) data to compare differences in fractional anisotropy (FA) and mean diffusivity (MD) between the three clinical groups and healthy control subjects. Further analyses were conducted to assess the relationship between these putative indices of white matter microstructure and clinical measures of disease severity and symptoms. In PSP, relative to controls, changes in DTI indices consistent with white matter tract degeneration were identified in the corpus callosum, corona radiata, corticospinal tract, superior longitudinal fasciculus, anterior thalamic radiation, superior cerebellar peduncle, medial lemniscus, retrolenticular and anterior limb of the internal capsule, cerebral peduncle and external capsule bilaterally, as well as the left posterior limb of the internal capsule and the right posterior thalamic radiation. MSA patients also displayed differences in the body of the corpus callosum corticospinal tract, cerebellar peduncle, medial lemniscus, anterior and superior corona radiata, posterior limb of the internal capsule external capsule and cerebral peduncle bilaterally, as well as the left anterior limb of the internal capsule and the left anterior thalamic radiation. No significant white matter abnormalities were observed in the PD group. Across groups, MD correlated positively with disease severity in all major white matter tracts. These results show widespread changes in white matter tracts in both PSP and MSA patients, even at a mid-point in the disease process, which are not found in patients with PD.
authors.affiliation: Institute of Psychiatry, King's College London, London, United Kingdom; National Institute for Health Research Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, London, United Kingdom; National Institute for Health Research Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, London, United Kingdom.
authors.forename: Amanda
authors.initials: A
authors.lastname: Worker
authors.affiliation: Institute of Psychiatry, King's College London, London, United Kingdom; King's College Hospital, London, United Kingdom.
authors.forename: Camilla
authors.initials: C
authors.lastname: Blain
authors.affiliation: King's College Hospital, London, United Kingdom.
authors.forename: Jozef
authors.initials: J
authors.lastname: Jarosz
authors.affiliation: Institute of Psychiatry, King's College London, London, United Kingdom; National Institute for Health Research Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, London, United Kingdom; National Institute for Health Research Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, London, United Kingdom; King's College Hospital, London, United Kingdom.
authors.forename: K Ray
authors.initials: KR
authors.lastname: Chaudhuri
authors.affiliation: Institute of Psychiatry, King's College London, London, United Kingdom.
authors.forename: Gareth J
authors.initials: GJ
authors.lastname: Barker
authors.affiliation: Institute of Psychiatry, King's College London, London, United Kingdom; National Institute for Health Research Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, London, United Kingdom.
authors.forename: Steve C R
authors.initials: SC
authors.lastname: Williams
authors.affiliation: Institute of Psychiatry, King's College London, London, United Kingdom; National Institute for Health Research Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, London, United Kingdom; National Institute for Health Research Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, London, United Kingdom.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Brown
authors.affiliation: Trafford Centre for Biomedical Research, Brighton and Sussex Medical School, University of Sussex, Falmer, Brighton, United Kingdom.
authors.forename: P Nigel
authors.initials: PN
authors.lastname: Leigh
authors.affiliation: Institute of Psychiatry, King's College London, London, United Kingdom; National Institute for Health Research Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, London, United Kingdom; National Institute for Health Research Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, London, United Kingdom.
authors.forename: Flavio
authors.initials: F
authors.lastname: Dell'Acqua
authors.affiliation: Institute of Psychiatry, King's College London, London, United Kingdom; National Institute for Health Research Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, London, United Kingdom; National Institute for Health Research Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King's College London, London, United Kingdom.
authors.forename: Andrew
authors.initials: A
authors.lastname: Simmons
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology; D016022:Case-Control Studies; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000175:diagnosis*; D010300:Parkinson Disease / Q000175:diagnosis*; D013494:Supranuclear Palsy, Progressive / Q000175:diagnosis*