The effect of tremor onset on middle cerebellar peduncle of Parkinson's disease.
The majority of studies of Parkinson's disease (PD) focused on basal ganglia initially; however, accumulating evidence suggests cerebellar involvement in pathophysiology. We aimed to investigate the effects of tremor onset on middle cerebellar peduncle (MCP) width of PD patients and of disease duration on differential diagnosis. We measured MCP width of 81 PD, 34 multiple system atrophy (MSA) and 16 normal controls, using MRI. A meta-analysis was performed including two previous and the present studies. We carried out correlation analysis between disease duration and MCP width separately in subgroup of PD with or without tremor onset. Receiver operating characteristic curves were analyzed. Our meta-analysis indicated that MCP width was significantly smaller in MSA relative to PD with homogeneous studies. There was significant correlation between disease duration and MCP width in PD without tremor onset. In contrast, there was no correlation observed in PD with tremor onset. Subclassification according to disease duration showed improved area under curve of PD vs. MSA with predominant parkinsonian features. MCP width could be a valuable tool for differential diagnosis. Our finding suggested that MCP was impaired in advanced stage of PD without tremor onset as part of the abnormality of the cerebellar system.
Department of Clinical Neuroscience, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan. Electronic address: dwsako@yahoo.co.jp.
Wataru
W
Sako
Department of Clinical Neuroscience, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
Nagahisa
N
Murakami
Department of Clinical Neuroscience, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
Yoshimichi
Y
Miyazaki
Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
Takashi
T
Abe
Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
Masafumi
M
Harada
Department of Clinical Neuroscience, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
Yuishin
Y
Izumi
Department of Clinical Neuroscience, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
Ryuji
R
Kaji
D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D065837:Middle Cerebellar Peduncle / Q000473:pathology*; D019578:Multiple System Atrophy / Q000473:pathology*; D009929:Organ Size; D010300:Parkinson Disease / Q000473:pathology*; D014202:Tremor / Q000473:pathology*
Cerebellum; Magnetic resonance imaging; Middle cerebellar peduncle; Multiple system atrophy; Parkinson's disease; Tremor