title: Potential of Diffusion Tensor Imaging and Relaxometry for the Detection of Specific Pathological Alterations in Parkinson's Disease (PD).
abstract: The purpose of the present study was to evaluate the potential of multimodal MR imaging including mean diffusivity (MD), fractional anisotropy (FA), relaxation rates R2 and R2* to detect disease specific alterations in Parkinson's Disease (PD). We enrolled 82 PD patients (PD-all) with varying disease durations (≤5 years: PD≤5, n = 43; >5 years: PD>5, n = 39) and 38 matched healthy controls (HC), receiving diffusion tensor imaging as well as R2 and R2* relaxometry calculated from multi-echo T2*-weighted and dual-echo TSE imaging, respectively. ROIs were drawn to delineate caudate nucleus (CN), putamen (PU), globus pallidus (GP) and substantia nigra (SN) on the co-registered maps. The SN was divided in 3 descending levels (SL 1-3). The most significant parameters were used for a flexible discrimination analysis (FDA) in a training collective consisting of 25 randomized subjects from each group in order to predict the classification of remaining subjects. PD-all showed significant increases in MD, R2 and R2* within SN and its subregions as well as in MD and R2* within different basal ganglia regions. Compared to the HC group, the PD≤5 and the PD>5 group showed significant MD increases within the SN and its lower two subregions, while the PD≤5 group exhibited significant increases in R2 and R2* within SN and its subregions, and tended to elevation within the basal ganglia. The PD>5 group had significantly increased MD in PU and GP, whereas the PD≤5 group presented normal MD within the basal ganglia. FDA achieved right classification in 84% of study participants. Micro-structural damage affects primarily the SN of PD patients and in later disease stages the basal ganglia. Iron contents of PU, GP and SN are increased at early disease stages of PD.
authors.affiliation: Department of Radiology, University Hospital, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria.
authors.forename: Regina
authors.initials: R
authors.lastname: Esterhammer
authors.affiliation: Department of Neurology, University Hospital, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria.
authors.forename: Klaus
authors.initials: K
authors.lastname: Seppi
authors.affiliation: Department of Neurology, University Hospital, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria.
authors.forename: Eva
authors.initials: E
authors.lastname: Reiter
authors.affiliation: Department of Neurology, University Hospital, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Pinter
authors.affiliation: Department of Neurology, University Hospital, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Mueller
authors.affiliation: Department of Radiology, University Hospital, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Kremser
authors.affiliation: Department of Radiology, University Hospital, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria.|Department of Radiology, University Hospital, Eberhard Karls University, Hoppe-Seyler-Str. 3, 72076, Tübingen, Germany.
authors.forename: Tanja
authors.initials: T
authors.lastname: Zitzelsberger
authors.affiliation: Department of Neurology, University Hospital, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Nocker
authors.affiliation: Department of Neurology, University Hospital, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria.
authors.forename: Christoph
authors.initials: C
authors.lastname: Scherfler
authors.affiliation: Department of Neurology, University Hospital, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria.
authors.forename: Werner
authors.initials: W
authors.lastname: Poewe
authors.affiliation: Department of Radiology, University Hospital, Innsbruck Medical University, Anichstrasse 35, 6020, Innsbruck, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Schocke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001479:Basal Ganglia / Q000473:pathology; D016022:Case-Control Studies; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D010300:Parkinson Disease / Q000175:diagnosis / Q000473:pathology*; D013378:Substantia Nigra / Q000473:pathology