title: Disease-specific structural changes in thalamus and dentatorubrothalamic tract in progressive supranuclear palsy.
abstract: BACKGROUND
  The aim of this study is to identify disease-specific changes of the thalamus, basal ganglia, pons, and midbrain in patients with progressive supranuclear palsy (PSP), Parkinson's disease (PD), and multiple system atrophy with predominant parkinsonism (MSA-P) using diffusion tensor imaging and volumetric analysis.
  
  
  METHODS
  MRI diffusion and volumetric data were acquired in a derivation of 30 controls and 8 patients with PSP and a validation cohort comprised of controls (n = 21) and patients with PSP (n = 27), PD (n = 10), and MSA-P (n = 11). Analysis was performed using regions of interest (ROI), tract-based spatial statistic (TBSS), and tractography and results compared between diagnostic groups.
  
  
  RESULTS
  In the derivation cohort, we observed increased mean diffusivity (MD) in the thalamus, superior cerebellar peduncle, and the midbrain in PSP compared to controls. Furthermore, volumetric analysis showed reduced thalamic volumes in PSP. In the validation cohort, the observations of increased MD were replicated by ROI-based analysis and in the thalamus by TBSS-based analysis. Such differences were not found for patients with PD in any of the cohorts. Tractography of the dentatorubrothalamic tract (DRTT) showed increased MD in PSP patients from both cohorts compared to controls and in the validation cohort in PSP compared to PD and MSA patients. Increased MD in the thalamus and along the DRTT correlated with disease stage and motor function in PSP.
  
  
  CONCLUSIONS
  Patients with PSP, but not PD or MSA-P, exhibit signs of structural abnormalities in the thalamus and in the DRTT. These changes are associated with disease stage and impaired motor function.
authors.affiliation: Department of Clinical Sciences, Lund University, Lund, Sweden. yulia.surova@med.lu.se.|Department of Neurology, Skåne University Hospital, 221 85, Lund, Sweden. yulia.surova@med.lu.se.
authors.forename: Yulia
authors.initials: Y
authors.lastname: Surova
authors.affiliation: Lund University Bioimaging Center, Lund University, Lund, Sweden.
authors.forename: Markus
authors.initials: M
authors.lastname: Nilsson
authors.affiliation: Center for Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden.
authors.forename: Jimmy
authors.initials: J
authors.lastname: Lätt
authors.affiliation: Department of Medical Radiation Physics, Lund University, Lund, Sweden.
authors.forename: Björn
authors.initials: B
authors.lastname: Lampinen
authors.affiliation: Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden.
authors.forename: Olof
authors.initials: O
authors.lastname: Lindberg
authors.affiliation: Department of Clinical Sciences, Lund University, Lund, Sweden.|Department of Neurology, Skåne University Hospital, 221 85, Lund, Sweden.
authors.forename: Sara
authors.initials: S
authors.lastname: Hall
authors.affiliation: Department of Clinical Sciences, Lund University, Lund, Sweden.|Department of Neurology, Skåne University Hospital, 221 85, Lund, Sweden.
authors.forename: Håkan
authors.initials: H
authors.lastname: Widner
authors.affiliation: Department of Neurology, Skåne University Hospital, 221 85, Lund, Sweden.|Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden.
authors.forename: Christer
authors.initials: C
authors.lastname: Nilsson
authors.affiliation: Department of Clinical Sciences, Lund University, Lund, Sweden.|Center for Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden.
authors.forename: Danielle
authors.initials: D
authors.lastname: van Westen
authors.affiliation: Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden.|Memory Clinic, Skåne University Hospital, Lund, Sweden.
authors.forename: Oskar
authors.initials: O
authors.lastname: Hansson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002529:Cerebellar Nuclei / Q000473:pathology*; D003937:Diagnosis, Differential; D056324:Diffusion Tensor Imaging / Q000379:methods; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy; D009434:Neural Pathways / Q000473:pathology; D010300:Parkinson Disease / Q000473:pathology*; D012012:Red Nucleus / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013494:Supranuclear Palsy, Progressive / Q000473:pathology*; D013788:Thalamus / Q000473:pathology*
keywords: Diffusion tensor imaging; Progressive supranuclear palsy; Tract-based spatial statistics; Tractography