title: Diffusion Kurtosis Imaging of Substantia Nigra Is a Sensitive Method for Early Diagnosis and Disease Evaluation in Parkinson's Disease.
abstract: Background. To diagnose Parkinson disease (PD) in an early stage and accurately evaluate severity, it is important to develop a sensitive method for detecting structural changes in the substantia nigra (SN). Method. Seventy-two untreated patients with early PD and 72 healthy controls underwent diffusion tensor and diffusion kurtosis imaging. Regions of interest were drawn in the rostral, middle, and caudal SN by two blinded and independent raters. Mean kurtosis (MK) and fractional anisotropy in the SN were compared between the groups. Receiver operating characteristic (ROC) and Spearman correlation analyses were used to compare the diagnostic accuracy and correlate imaging findings with Hoehn-Yahr (H-Y) staging and part III of the Unified Parkinson's Disease Rating Scale (UPDRS-III). Result. MK in the SN was increased significantly in PD patients compared with healthy controls. The area under the ROC curve was 0.976 for MK in the SN (sensitivity, 0.944; specificity, 0.917). MK in the SN had a positive correlation with H-Y staging and UPDRS-III scores. Conclusion. Diffusion kurtosis imaging is a sensitive method for PD diagnosis and severity evaluation. MK in the SN is a potential biomarker for imaging studies of early PD that can be widely used in clinic.
authors.affiliation: Southern Medical University, Guangzhou, Guangdong 510515, China; Department of Neurology, Guangdong Neuroscience Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, China; Department of Neurology, The First People's Hospital of Foshan, Foshan, Guangdong 528000, China.
authors.forename: Guohua
authors.initials: G
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Guangdong Neuroscience Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, China.
authors.forename: Yuhu
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Neurology, The First People's Hospital of Foshan, Foshan, Guangdong 528000, China.
authors.forename: Chengguo
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Neurology, The First People's Hospital of Foshan, Foshan, Guangdong 528000, China.
authors.forename: Yukai
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Neurology, Guangdong Neuroscience Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, China.
authors.forename: Guixian
authors.initials: G
authors.lastname: Ma
authors.affiliation: Department of Neurology, Guangdong Neuroscience Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Nie
authors.affiliation: Department of Neurology, The First People's Hospital of Foshan, Foshan, Guangdong 528000, China.
authors.forename: Haiqun
authors.initials: H
authors.lastname: Xie
authors.affiliation: Department of Neurology, The First People's Hospital of Foshan, Foshan, Guangdong 528000, China.
authors.forename: Jianping
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Neurology, Guangdong Neuroscience Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong 510080, China.
authors.forename: Lijuan
authors.initials: L
authors.lastname: Wang