title: Loss of substantia nigra hyperintensity on 7 Tesla MRI of Parkinson's disease, multiple system atrophy, and progressive supranuclear palsy.
abstract: Seven Tesla (7T) MRI can visualize anatomical alterations occurring in a hyperintense structure of the substantia nigra in Parkinson's disease (PD).
  
  
  
  We investigated whether 7T MRI can detect the loss of substantia nigra hyperintensity in patients with PD, multiple system atrophy (MSA), and progressive supranuclear palsy (PSP).
  
  
  
  Using 7T MRI, we evaluated 26 healthy subjects, 30 patients with PD, 7 patients with MSA, and 3 patients with PSP. Two blinded readers independently assessed the images. We carried out a comparative analysis of five patients with hemiparkinsonism via (123)I-2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl)-nortropane ((123)I-FP-CIT) SPECT.
  
  
  
  7T MRI revealed a definitive shape of nigral hyperintensity in healthy subjects, nearly identical to neuropathological characterization of nigrosome 1, and enabled instantaneous determination of its presence or absence in all subjects. Nigral hyperintensity was lost in all patients with PD, MSA with predominant parkinsonism, and PSP. One of five patients with MSA with predominant cerebellar ataxia showed an intact nigral hyperintensity. The side effects were mild and tolerable, and imaging was successful in patients with dyskinesia. Motion artifact incidence was higher in elderly subjects. In hemiparkinsonism cases, we observed partial loss of nigral hyperintensity on the side of less reduced (123)I-FP-CIT binding, suggesting an ongoing iron deposition on the unaffected side in hemiparkinsonism.
  
  
  
  The present findings suggest that 7T MRI represents an excellent tool for evaluating nigral hyperintensity in PD, MSA, and PSP, with tolerable side effects and limited motion artifacts. Thus, imaging of parkinsonism may benefit from using 7T MRI.
authors.affiliation: Department of Neurology, Seoul National University Bundang Hospital, Seoul National University Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
authors.forename: Jong-Min
authors.initials: JM
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, School of Medicine, Neuroscience Research Institute, Gachon University of Medicine and Science, Incheon, South Korea.
authors.forename: Hye-Jin
authors.initials: HJ
authors.lastname: Jeong
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seoul National University Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
authors.forename: Yun Jung
authors.initials: YJ
authors.lastname: Bae
authors.affiliation: Department of Neurosurgery, School of Medicine, Neuroscience Research Institute, Gachon University of Medicine and Science, Incheon, South Korea.
authors.forename: Sung-Yeon
authors.initials: SY
authors.lastname: Park
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, Seoul National University Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
authors.forename: Eunhee
authors.initials: E
authors.lastname: Kim
authors.affiliation: Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
authors.forename: Seo Young
authors.initials: SY
authors.lastname: Kang
authors.affiliation: Department of Neurology, Chungnam National University Hospital, Daejeon, South Korea.
authors.forename: Eung Seok
authors.initials: ES
authors.lastname: Oh
authors.affiliation: Department of Neurology, Seoul National University Bundang Hospital, Seoul National University Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
authors.forename: Kyeong Joon
authors.initials: KJ
authors.lastname: Kim
authors.affiliation: Department of Neurology, Seoul National University Bundang Hospital, Seoul National University Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
authors.forename: Beomseok
authors.initials: B
authors.lastname: Jeon
authors.affiliation: Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University Hospital, Seoul National University College of Medicine, Seongnam, South Korea; Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea.
authors.forename: Sang Eun
authors.initials: SE
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, School of Medicine, Neuroscience Research Institute, Gachon University of Medicine and Science, Incheon, South Korea.
authors.forename: Zang-Hee
authors.initials: ZH
authors.lastname: Cho
authors.affiliation: Department of Neurosurgery, School of Medicine, Neuroscience Research Institute, Gachon University of Medicine and Science, Incheon, South Korea. Electronic address: neurokim@gachon.ac.kr.
authors.forename: Young-Bo
authors.initials: YB
authors.lastname: Kim
mesh_terms: D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods* / Q000592:standards; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000000981:diagnostic imaging* / Q000453:epidemiology; D010300:Parkinson Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D011446:Prospective Studies; D013378:Substantia Nigra / Q000000981:diagnostic imaging*; D013494:Supranuclear Palsy, Progressive / Q000000981:diagnostic imaging* / Q000453:epidemiology; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods / Q000592:standards
keywords: Magnetic resonance imaging; Multiple system atrophy; Parkinson's disease; Progressive supranuclear palsy