title: White matter and cortical changes in atypical parkinsonisms: A multimodal quantitative MR study.
abstract: To evaluate white matter and cortical changes in patients with parkinsonisms and healthy controls (HC), applying both hypothesis-free and regions of interest (ROI)-based advanced brain MR analyses.
  
  
  
  Twenty-five patients with Progressive Supranuclear Palsy - Richardson's Syndrome (PSP-RS), nine with cerebellar and nine with parkinsonian Multiple System Atrophy variants (MSA-C and MSA-P), forty-seven with Parkinson's Disease (PD) and twenty-seven HC underwent a 1.5 T brain-MR protocol including high-resolution 3D T1-weighted and 25-direction diffusion tensor imaging sequences. We performed cortical and white matter analysis by using vertex-based cortical thickness evaluation and Tract Based Spatial Statistics (TBSS), followed by a ROI-based cortical thickness analysis and probabilistic tractography of cortico-spinal tract (CST), and middle and superior cerebellar peduncles (MCP and SCP).
  
  
  
  In PSP-RS, both ROIs-based and voxel-wise analyses demonstrated significant thinning of the pre-central cortices and diffuse white matter alterations involving supra- and infratentorial compartments. Along-tract tractography analysis of CST showed a significantly higher MD in PSP-RS vs PD and HC limited to the portion of the tract within the corona radiata. In MSA-C, a predominant involvement of MCPs was evident, while alterations in MCPs in MSA-P and in SCPs in PSP-RS and MSA-C were also present.
  
  
  
  Specific patterns of cortical and white matter changes in atypical parkinsonism patients reflect the neuropathological and clinical features of these disorders. This study shows that quantitative brain MR techniques can detect significant changes that help to elucidate the physiopathology of movement disorders and support their differential diagnosis.
authors.affiliation: Functional MR Unit, Policlinico S. Orsola - Malpighi, via Massarenti 9, 40138, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, via U. Foscolo 7, 40123, Bologna, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Zanigni
authors.affiliation: Functional MR Unit, Policlinico S. Orsola - Malpighi, via Massarenti 9, 40138, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, via U. Foscolo 7, 40123, Bologna, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Evangelisti
authors.affiliation: Functional MR Unit, Policlinico S. Orsola - Malpighi, via Massarenti 9, 40138, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, via U. Foscolo 7, 40123, Bologna, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Testa
authors.affiliation: Functional MR Unit, Policlinico S. Orsola - Malpighi, via Massarenti 9, 40138, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, via U. Foscolo 7, 40123, Bologna, Italy.
authors.forename: David N
authors.initials: DN
authors.lastname: Manners
authors.affiliation: Department of Biomedical and Neuromotor Sciences, University of Bologna, via U. Foscolo 7, 40123, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, via Altura 3, 40139, Bologna, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Calandra-Buonaura
authors.affiliation: Neurology Unit, Policlinico S. Orsola - Malpighi, via Massarenti 9, 40138, Bologna, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Guarino
authors.affiliation: IRCCS Istituto delle Scienze Neurologiche di Bologna, via Altura 3, 40139, Bologna, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Gabellini
authors.affiliation: Functional MR Unit, Policlinico S. Orsola - Malpighi, via Massarenti 9, 40138, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, via U. Foscolo 7, 40123, Bologna, Italy.
authors.forename: Laura Ludovica
authors.initials: LL
authors.lastname: Gramegna
authors.affiliation: Department of Biomedical and Neuromotor Sciences, University of Bologna, via U. Foscolo 7, 40123, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, via Altura 3, 40139, Bologna, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Giannini
authors.affiliation: Department of Biomedical and Neuromotor Sciences, University of Bologna, via U. Foscolo 7, 40123, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, via Altura 3, 40139, Bologna, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Sambati
authors.affiliation: Department of Biomedical and Neuromotor Sciences, University of Bologna, via U. Foscolo 7, 40123, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, via Altura 3, 40139, Bologna, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Cortelli
authors.affiliation: Functional MR Unit, Policlinico S. Orsola - Malpighi, via Massarenti 9, 40138, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, via U. Foscolo 7, 40123, Bologna, Italy. Electronic address: raffaele.lodi@unibo.it.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Lodi
authors.affiliation: Functional MR Unit, Policlinico S. Orsola - Malpighi, via Massarenti 9, 40138, Bologna, Italy; Department of Biomedical and Neuromotor Sciences, University of Bologna, via U. Foscolo 7, 40123, Bologna, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Tonon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002540:Cerebral Cortex / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000000981:diagnostic imaging*; D010300:Parkinson Disease / Q000000981:diagnostic imaging*; D013494:Supranuclear Palsy, Progressive / Q000000981:diagnostic imaging*; D066127:White Matter / Q000000981:diagnostic imaging*
keywords: MRI; Multiple System Atrophy; Parkinson's disease; Progressive Supranuclear Palsy; Tractography