Usefulness of diffusion-tensor MRI in the diagnosis of Parkinson variant of multiple system atrophy and Parkinson's disease: a valuable tool to differentiate between them?
OBJECTIVE
To evaluate the differences between patients with Parkinson's disease (PD) and Parkinson variant of multiple system atrophy (MSAp) at fractional anisotropy (FA) in the white matter when using the tract-based spatial statistics (TBSS) algorithm to provide objective markers for a differential diagnosis.


METHODS
Diffusion-tensor imaging (DTI) data were acquired from 18 PD patients, 20 MSAp patients, and 24 healthy controls using a GE 3 T Signa HDx magnetic resonance imaging (MRI) system. The hypothesis-free whole-brain analysis (TBSS), focusing on global white matter microstructural deterioration, was adopted based on comparison among groups. Furthermore, regions of interest (ROIs) were drawn on the major fibre bundles showing abnormalities in TBSS.


RESULTS
In the MSAp group, FA values significantly decreased in the middle cerebellar peduncle (MCP), pontine crossing tract, and corticospinal tract bilaterally. In the PD group, FA values significantly decreased in multiple supratentorial areas including the corpus callosum (CC), fornix, and left hippocampus.


CONCLUSIONS
DTI may be an effective tool to discover pathological differences between MSAp and PD. To substantially assist the non-invasive differential diagnosis of MSAp and PD, FA measurements should not only be limited to the MCP but also the CC.
Department of Radiology, The First Hospital, China Medical University, #155, Nanjing North St., Heping Dist., Shenyang, Liaoning 110001, China.
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Chen
Department of Radiology, The First Hospital, China Medical University, #155, Nanjing North St., Heping Dist., Shenyang, Liaoning 110001, China. Electronic address: fanguog@sina.com.
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Fan
Department of Radiology, The First Hospital, China Medical University, #155, Nanjing North St., Heping Dist., Shenyang, Liaoning 110001, China.
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Sun
Department of Neurology, The First Hospital, China Medical University, #155, Nanjing North St., Heping Dist., Shenyang, Liaoning 110001, China.
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Shang
Department of Radiology, The First Affiliated Hospital of Zhengzhou University, #1, East Jian She Road, Zhengzhou, Henan 450052, China.
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Shi
Department of Radiology, The First Hospital, China Medical University, #155, Nanjing North St., Heping Dist., Shenyang, Liaoning 110001, China.
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Wang
Department of Radiology, The First Hospital, China Medical University, #155, Nanjing North St., Heping Dist., Shenyang, Liaoning 110001, China.
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Lv
Department of Radiology, The First Hospital, China Medical University, #155, Nanjing North St., Heping Dist., Shenyang, Liaoning 110001, China.
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Wu
D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000000981:diagnostic imaging*; D010300:Parkinson Disease / Q000000981:diagnostic imaging*