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Jung JH, Kim YJ, Chung SJ, Yoo HS, Lee YH, Baik K, Jeong SH, Lee YG, Lee HS, Ye BS, Sohn YH, Jeong Y, Lee PH. White matter connectivity networks predict levodopa-induced dyskinesia in Parkinson's disease. J Neurol 2021; 269:2948-2960. [PMID: 34762146 DOI: 10.1007/s00415-021-10883-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/22/2021] [Accepted: 10/29/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although levodopa-induced dyskinesia-relevant white matter change has been evaluated, it is uncertain whether these changes may reflect the underlying predisposing conditions leading to the development of levodopa-induced dyskinesia. OBJECTIVE To elucidate the role of white matter connectivity networks in the development of levodopa-induced dyskinesia in drug-naïve Parkinson's disease. METHODS We recruited 30 patients who developed levodopa-induced dyskinesia within 5 years from MRI acquisition (vulnerable-group), 47 patients who had not developed levodopa-induced dyskinesia within 5 years (resistant-group), and 28 controls. We performed comparative analyses of whole-brain white matter integrity and connectivity using tract-based spatial and network- and degree-based statistics. We evaluated the predictability of levodopa-induced dyskinesia development and relationship with its latency, using the average connectivity strength as a predictor in Cox- and linear-regression, respectively. RESULTS Mean-diffusivity was lower mainly at the left frontal region in the vulnerable-group compared to the resistant-group. Network-based statistics identified a subnetwork consisting of the bilateral fronto-striato-pallido-thalamic and lateral parietal regions (subnetwork A) and degree-based statistics identified four subnetworks (hub-subnetwork) consisting of edges centered on the left superior frontal gyrus, left putamen, left insular, or left precentral gyrus, where the vulnerable-group had stronger connectivity compared to the resistant-group. Stronger connectivity within the subnetwork A and hub-subnetwork centered on the left superior frontal gyrus was a predictor of levodopa-induced dyskinesia development independent of known risk factors and had an inverse relationship with its latency. CONCLUSIONS Our data suggest that white matter connectivity subnetworks within corticostriatal regions play a pivotal role in the development of levodopa-induced dyskinesia.
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Affiliation(s)
- Jin Ho Jung
- Department of Neurology, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea
| | - Yae Ji Kim
- Program of Brain and Cognitive Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
- KI for Health Science and Technology, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
- Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea
| | - Han Soo Yoo
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Yang Hyun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Kyoungwon Baik
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Seong Ho Jeong
- Department of Neurology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, South Korea
| | - Young Gun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, South Korea
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea
| | - Yong Jeong
- Program of Brain and Cognitive Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea.
- KI for Health Science and Technology, Korea Advanced Institute of Science and Technology, Daejeon, South Korea.
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea.
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.
- Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea.
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2
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Zhang Y, Burock MA. Diffusion Tensor Imaging in Parkinson's Disease and Parkinsonian Syndrome: A Systematic Review. Front Neurol 2020; 11:531993. [PMID: 33101169 PMCID: PMC7546271 DOI: 10.3389/fneur.2020.531993] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 08/18/2020] [Indexed: 12/21/2022] Open
Abstract
Diffusion tensor imaging (DTI) allows measuring fractional anisotropy and similar microstructural indices of the brain white matter. Lower than normal fractional anisotropy as well as higher than normal diffusivity is associated with loss of microstructural integrity and neurodegeneration. Previous DTI studies in Parkinson's disease (PD) have demonstrated abnormal fractional anisotropy in multiple white matter regions, particularly in the dopaminergic nuclei and dopaminergic pathways. However, DTI is not considered a diagnostic marker for the earliest Parkinson's disease since anisotropic alterations present a temporally divergent pattern during the earliest Parkinson's course. This article reviews a majority of clinically employed DTI studies in PD, and it aims to prove the utilities of DTI as a marker of diagnosing PD, correlating clinical symptomatology, tracking disease progression, and treatment effects. To address the challenge of DTI being a diagnostic marker for early PD, this article also provides a comparison of the results from a longitudinal, early stage, multicenter clinical cohort of Parkinson's research with previous publications. This review provides evidences of DTI as a promising marker for monitoring PD progression and classifying atypical PD types, and it also interprets the possible pathophysiologic processes under the complex pattern of fractional anisotropic changes in the first few years of PD. Recent technical advantages, limitations, and further research strategies of clinical DTI in PD are additionally discussed.
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Affiliation(s)
- Yu Zhang
- Department of Psychiatry, War Related Illness and Injury Study Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
| | - Marc A Burock
- Department of Psychiatry, Mainline Health, Bryn Mawr Hospital, Bryn Mawr, PA, United States
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Feng Y, Yan W, Wang J, Song J, Zeng Q, Zhao C. Local White Matter Fiber Clustering Differentiates Parkinson's Disease Diagnoses. Neuroscience 2020; 435:146-160. [PMID: 32272152 DOI: 10.1016/j.neuroscience.2020.03.049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 10/24/2022]
Abstract
Scans without evidence of dopaminergic deficit (SWEDD) patients are often misdiagnosed with Parkinson's disease (PD) but have normal dopamine transporter scans. We hypothesised that white matter tracts associated with motor and cognition functions may be affected differently by SWEDD and PD. Automatically annotated fibre clustering (AAFC) is a novel clustering method based on diffusion magnetic resonance imaging (dMRI) tractography that enables highly robust reconstruction of white matter tracts that are composed of corresponding clusters. This study aimed to investigate the white matter properties in the subdivisions of white matter tracts among SWEDD and PD groups. We applied AAFC to identify white matter tracts related to motion and cognition functions in the dataset consisting of SWEDD (n = 22), PD (n = 30) and normal control (NC) (n = 30). Then, we resampled 200 nodes along fibres of cluster, and the diffusion metric values corresponding to each node were calculated and used for comparison. Compared with NC, PD showed significant difference (p < 0.05) in two clusters in thalamo-frontal (TF), one cluster in thalamo-parietal (TP) and one cluster in thalamo-occipital (TO), whereas SWEDD presented no significant difference. Three clusters in cingulum bundle (CB) commonly exhibited significant differences in PD versus SWEDD and NC versus SWEDD. The support vector machine classifier achieved high accuracies in PD-NC, PD-SWEDD and NC-SWEDD classifications. This outcome validated these local white matter differences were useful to separate the three groups. These results suggest that PD exerts more significant effects on thalamo tracts than SWEDD, and unique microstructural changes occur in CB tract in SWEDD.
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Affiliation(s)
- Yuanjing Feng
- Institute of Information Processing and Automation, College of Information Engineering, Zhejiang University of Technology, Hangzhou 310023, China; Zhejiang Provincial United Key Laboratory of Embedded Systems, Hangzhou 310023, China.
| | - Wenxuan Yan
- Institute of Information Processing and Automation, College of Information Engineering, Zhejiang University of Technology, Hangzhou 310023, China
| | - Jingqiang Wang
- Institute of Information Processing and Automation, College of Information Engineering, Zhejiang University of Technology, Hangzhou 310023, China
| | - Jiahao Song
- Institute of Information Processing and Automation, College of Information Engineering, Zhejiang University of Technology, Hangzhou 310023, China
| | - Qingrun Zeng
- Institute of Information Processing and Automation, College of Information Engineering, Zhejiang University of Technology, Hangzhou 310023, China
| | - Changchen Zhao
- Institute of Information Processing and Automation, College of Information Engineering, Zhejiang University of Technology, Hangzhou 310023, China
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Andica C, Kamagata K, Hatano T, Saito Y, Uchida W, Ogawa T, Takeshige-Amano H, Hagiwara A, Murata S, Oyama G, Shimo Y, Umemura A, Akashi T, Wada A, Kumamaru KK, Hori M, Hattori N, Aoki S. Neurocognitive and psychiatric disorders-related axonal degeneration in Parkinson's disease. J Neurosci Res 2020; 98:936-949. [PMID: 32026517 PMCID: PMC7154645 DOI: 10.1002/jnr.24584] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 12/05/2019] [Accepted: 01/06/2020] [Indexed: 11/30/2022]
Abstract
Neurocognitive and psychiatric disorders have significant consequences for quality of life in patients with Parkinson's disease (PD). In the current study, we evaluated microstructural white matter (WM) alterations associated with neurocognitive and psychiatric disorders in PD using neurite orientation dispersion and density imaging (NODDI) and linked independent component analysis (LICA). The indices of NODDI were compared between 20 and 19 patients with PD with and without neurocognitive and psychiatric disorders, respectively, and 25 healthy controls using tract‐based spatial statistics and tract‐of‐interest analyses. LICA was applied to model inter‐subject variability across measures. A widespread reduction in axonal density (indexed by intracellular volume fraction [ICVF]) was demonstrated in PD patients with and without neurocognitive and psychiatric disorders, as compared with healthy controls. Compared with patients without neurocognitive and psychiatric disorders, patients with neurocognitive and psychiatric disorders exhibited more extensive (posterior predominant) decreases in axonal density. Using LICA, ICVF demonstrated the highest contribution (59% weight) to the main effects of diagnosis that reflected widespread decreases in axonal density. These findings suggest that axonal loss is a major factor underlying WM pathology related to neurocognitive and psychiatric disorders in PD, whereas patients with neurocognitive and psychiatric disorders had broader axonal pathology, as compared with those without. LICA suggested that the ICVF can be used as a useful biomarker of microstructural changes in the WM related to neurocognitive and psychiatric disorders in PD.
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Affiliation(s)
- Christina Andica
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Koji Kamagata
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Taku Hatano
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuya Saito
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Radiological Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Wataru Uchida
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Radiological Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan
| | - Takashi Ogawa
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | | | - Akifumi Hagiwara
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Syo Murata
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Genko Oyama
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yashushi Shimo
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Atsushi Umemura
- Department of Neurosurgery, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Toshiaki Akashi
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Akihiko Wada
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kanako K Kumamaru
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Masaaki Hori
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan.,Department of Radiology, Toho University Omori Medical Center, Tokyo, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Shigeki Aoki
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
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5
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Abbasi N, Fereshtehnejad SM, Zeighami Y, Larcher KMH, Postuma RB, Dagher A. Predicting severity and prognosis in Parkinson's disease from brain microstructure and connectivity. NEUROIMAGE-CLINICAL 2019; 25:102111. [PMID: 31855654 PMCID: PMC6926369 DOI: 10.1016/j.nicl.2019.102111] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 11/26/2019] [Accepted: 11/27/2019] [Indexed: 12/25/2022]
Abstract
White matter disruption occurs in Parkinson's disease across several brain regions. DTI properties could identify clinically distinct subtypes of Parkinson's disease. Structural neural disruption can predict clinical outcomes in Parkinson's disease.
Objectives: Investigating biomarkers to demonstrate progression of Parkinson's disease (PD) is of high priority. We investigated the association of brain structural properties with progression of clinical outcomes and their ability to differentiate clinical subtypes of PD. Methods: A comprehensive set of clinical features was evaluated at baseline and 4.5-year follow-up for 144 de-novo PD patients from the Parkinson's Progression Markers Initiative. We created a global composite outcome (GCO) by combining z-scores of non-motor and motor symptoms, motor signs, overall activities of daily living and global cognition, as a single numeric indicator of prognosis. We classified patients into three subtypes based on multi-domain clinical criteria: ‘mild motor-predominant’, ‘intermediate’ and ‘diffuse-malignant’. We analyzed diffusion-weighted scans at the early drug-naïve stage and extracted fractional anisotropy and mean diffusivity (MD) of basal ganglia and cortical sub-regions. Then, we employed graph theory to calculate network properties and used network-based statistic to investigate our primary hypothesis. Results: Baseline MD of globus pallidus was associated with worsening of motor severity, cognition, and GCO after 4.5 years of follow-up. Connectivity disruption at baseline was correlated with decline in cognition, and increase in GCO. Baseline MD of nucleus accumbens, globus pallidus and basal-ganglia were linked to clinical subtypes at 4.5-year of follow-up. Disruption in sub-cortical networks associated with being subtyped as ‘diffuse-malignant’ versus ‘mild motor-predominant’ after 4.5 years. Conclusions: Diffusion imaging analysis at the early de-novo stage of PD was able to differentiate clinical sub-types of PD after 4.5 years and was highly associated with future clinical outcomes of PD.
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Affiliation(s)
- Nooshin Abbasi
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, 3801 University St., Montreal, Quebec H3A 2B4, Canada.
| | - Seyed-Mohammad Fereshtehnejad
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada; Division of Neurology, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada; Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institute, Stockholm, Sweden
| | - Yashar Zeighami
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, 3801 University St., Montreal, Quebec H3A 2B4, Canada
| | | | - Ronald B Postuma
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada; Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
| | - Alain Dagher
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, 3801 University St., Montreal, Quebec H3A 2B4, Canada
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Rau YA, Wang SM, Tournier JD, Lin SH, Lu CS, Weng YH, Chen YL, Ng SH, Yu SW, Wu YM, Tsai CC, Wang JJ. A longitudinal fixel-based analysis of white matter alterations in patients with Parkinson's disease. Neuroimage Clin 2019; 24:102098. [PMID: 31795054 PMCID: PMC6889638 DOI: 10.1016/j.nicl.2019.102098] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 10/01/2019] [Accepted: 11/16/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Disruption to white matter pathways is an important contributor to the pathogenesis of Parkinson's disease. Fixel-based analysis has recently emerged as a useful fiber-specific tool for examining white matter structure. In this longitudinal study, we used Fixel-based analysis to investigate white matter changes occurring over time in patients with Parkinson's disease. METHODS Fifty patients with idiopathic Parkinson's disease (27 men and 23 women; mean age: 61.8 ± 6.1 years), were enrolled. Diffusion-weighted imaging and clinical examinations were performed at three different time points (baseline, first follow-up [after a mean of 24±2 months], and second follow-up [after a mean of 40 ± 3 months]). Additional 76 healthy control subjects (38 men and 38 women; mean age: 62.3 ± 5.5 years) were examined at baseline. The following fixel-based metrics were obtained: fiber density (FD), fiber bundle cross-section (FC), and a combined measure of both (FDC). Paired comparisons of metrics between three different time points were performed in patients. Linear regression was implemented between longitudinal changes of fixel-based metrics and the corresponding modifications in clinical parameters. A family-wise error corrected p < 0.05 was considered statistically significant. RESULTS AND DISCUSSIONS Early degeneration in the splenium of corpus callosum was identified as a typical alteration of Parkinson's disease over time. At follow-up, we observed significant FDC reductions compared with baseline in white matter, noticeably in corpus callosum; tapetum; cingulum, posterior thalamic radiation, corona radiata, and sagittal stratum. We also identified significant FC decreases that reflected damage to white matter structures involved in Parkinson's disease -related pathways. Fixel-based metrics were found to relate with a deterioration of 39-item Parkinson's Disease Questionnaire, Unified Parkinson's Disease Rating Scale and activity of daily living. A Parkinson's disease -facilitated aging effect was observed in terms of white matter disruption. CONCLUSION This study provides a thorough fixel-based profile of longitudinal white matter alterations occurring in patients with Parkinson's disease and new evidence of FC as an important role in white matter degeneration in this setting.
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Affiliation(s)
- Yi-Ai Rau
- Division of Chinese Acupuncture and Traumatology, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Shi-Ming Wang
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Jacques-Donald Tournier
- Division of Imaging Sciences & Biomedical Engineering, King's College London, London, United Kingdom
| | - Sung-Han Lin
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Chin-Song Lu
- Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan; Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Hsin Weng
- Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan; Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yao-Liang Chen
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan; Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Shu-Hang Ng
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan; Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Shao-Wen Yu
- Division of Chinese Acupuncture and Traumatology, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Yi-Ming Wu
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan; Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
| | - Chih-Chien Tsai
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jiun-Jie Wang
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan; Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan; Healthy Aging Research Center, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Medical Imaging Research Center, Institute for Radiological Research, Chang Gung University/Chang Gung Memorial Hospital, Taoyuan, Taiwan.
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Li M, Liu Y, Chen H, Hu G, Yu S, Ruan X, Luo Z, Wei X, Xie Y. Altered Global Synchronizations in Patients With Parkinson's Disease: A Resting-State fMRI Study. Front Aging Neurosci 2019; 11:139. [PMID: 31293411 PMCID: PMC6603131 DOI: 10.3389/fnagi.2019.00139] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 05/23/2019] [Indexed: 01/13/2023] Open
Abstract
Background: Abnormalities of cognitive and movement functions are widely reported in Parkinson’s disease (PD). The mechanisms therein are complicated and assumed to a coordination of various brain regions. This study explored the alterations of global synchronizations of brain activities and investigated the neural correlations of cognitive and movement function in PD patients. Methods: Thirty-five age-matched patients with PD and 35 normal controls (NC) were enrolled in resting-state functional magnetic resonance imaging (rs-fMRI) scanning. Degree centrality (DC) was calculated to measure the global synchronizations of brain activity for two groups. Neural correlations between DC and cognitive function Frontal Assessment Battery (FAB), as well as movement function Unified Parkinson’s Disease Rating Scale (UPDRS-III), were examined across the whole brain within Anatomical Automatic Labeling (AAL) templates. Results: In the PD group, increased DC was observed in left fusiform gyrus extending to inferior temporal gyrus, left middle temporal gyrus (MTG) and angular gyrus, while it was decreased in right inferior opercular-frontal gyrus extending to superior temporal gyrus (STG). The DC in a significant region of the fusiform gyrus was positively correlated with UPDRS-III scores in PD (r = 0.41, p = 0.0145). Higher FAB scores were shown in NC than PD (p < 0.0001). Correlative analysis of PD between DC and FAB showed negative results (p < 0.05) in frontal cortex, whereas positive in insula and cerebellum. As for the correlations between DC and UPDRS-III, negative correlation (p < 0.05) was observed in bilateral inferior parietal lobule (IPL) and right cerebellum, whereas positive correlation (p < 0.05) in bilateral hippocampus and para-hippocampus gyrus (p < 0.01). Conclusion: The altered global synchronizations revealed altered cognitive and movement functions in PD. The findings suggested that the global functional connectivity in fusiform gyrus, cerebellum and hippocampus gyrus are critical regions in the identification of cognitive and movement functions in PD. This study provides new insights on the interactions among global coordination of brain activity, cognitive and movement functions in PD.
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Affiliation(s)
- Mengyan Li
- Department of Neurology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Yanjun Liu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Haobo Chen
- Department of Neurology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Guihe Hu
- Department of Neurology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Shaode Yu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China.,Department of Radiation Oncology, Southwestern Medical Center, University of Texas, Dallas, TX, United States
| | - Xiuhang Ruan
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | | | - Xinhua Wei
- Department of Radiology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Yaoqin Xie
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
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8
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Sobhani S, Rahmani F, Aarabi MH, Sadr AV. Exploring white matter microstructure and olfaction dysfunction in early parkinson disease: diffusion MRI reveals new insight. Brain Imaging Behav 2019; 13:210-219. [PMID: 29134611 DOI: 10.1007/s11682-017-9781-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Olfaction dysfunction is considered as a robust marker of prodromal Parkinson disease (PD). Measurement of olfaction function as a screening test is unsatisfactory due to long lead time interval and low specificity for detection of PD. Use of imaging markers might yield more accurate predictive values and provide bases for combined use of imaging and clinical markers for early PD. Diffusion MRI connectometry was conducted on 85 de novo PD patients in and 36 healthy controls to find: first, white matter tracts with significant difference in quantitative anisotropy between PD groups with various degrees of olfaction dysfunction and second, second fibers with correlation with University of Pennsylvania Smell Identification Test (UPSIT) score in each group using a multiple regression analysis considering age, sex, GDS and MoCA score. Local connectomes were determined in seven of all the possible comparisons, correcting for false discovery rate (FDR). PD patients with anosmia and normal olfaction had the highest number of fibers with decreased connectivity in left inferior longitudinal fasciculus, bilateral fornix, bilateral middle cerebellar peduncle (MCP), bilateral cingulum, bilateral corticospinal tract (CST) and body, genu and splenium of corpus callosum (CC) (FDR = 0.0013). In multiple regression analysis, connectivity in the body, genu and splenium of CC and bilateral fornix had significant negative correlation (FDR between 0.019 and 0.083), and bilateral cingulum and MCP had significant positive correlation (FDR between 0.022 and 0.092) with UPSIT score. White matter connectivity in healthy controls could not be predicted by UPSIT score using the same model. The results of this study provide compelling evidence that microstructural degenerative changes in these areas underlie the clinical phenotype of prodromal olfaction dysfunction in PD and that diffusion parameters of these areas might be able to serve as signature markers for early detection of PD. This is the first report that confirms a discriminative role for UPSIT score in identifying PD specific changes in white matter microstructure. Our results open a window to identify microstructural signatures of prodromal PD in white matter.
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Affiliation(s)
- Soheila Sobhani
- Basir Eye Health Research Center, Tehran, Iran
- Neuroimaging Network (NIN), Universal Scientific Education and Research Network (USERN), Children's Medical Center Hospital, Tehran, 14194, Iran
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Rahmani
- Neuroimaging Network (NIN), Universal Scientific Education and Research Network (USERN), Children's Medical Center Hospital, Tehran, 14194, Iran.
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mohammad Hadi Aarabi
- Basir Eye Health Research Center, Tehran, Iran
- Neuroimaging Network (NIN), Universal Scientific Education and Research Network (USERN), Children's Medical Center Hospital, Tehran, 14194, Iran
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Vafaei Sadr
- Department of Physics, Shahid Beheshti University, G.C., Evin, Tehran, Iran
- Département de Physique Théorique and Center for Astroparticle Physics, Université de Genève, Geneva, Switzerland
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Carmona Arroyave JA, Tobón Quintero CA, Suárez Revelo JJ, Ochoa Gómez JF, García YB, Gómez LM, Pineda Salazar DA. Resting functional connectivity and mild cognitive impairment in Parkinson’s disease. An electroencephalogram study. FUTURE NEUROLOGY 2019. [DOI: 10.2217/fnl-2018-0048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objective: Parkinson’s disease (PD) is characterized by cognitive deficits. There is not clarity about electroencephalogram (EEG) connectivity related to the cognitive profile of patients. Our objective was to evaluate connectivity over resting EEG in nondemented PD. Methods: PD subjects with and without mild cognitive impairment (MCI) were assessed using coherence from resting EEG for local, intra and interhemispheric connectivity. Results: PD subjects without MCI (PD-nMCI) had lower intra and interhemispheric coherence in alpha2 compared with controls. PD with MCI (PD-MCI) showed higher intra and posterior interhemispheric coherence in alpha2 and beta1, respectively, in comparison to PD-nMCI. PD-MCI presented lower frontal coherence in beta frequencies compared with PD-nMCI. Conclusion: EEG coherence measures indicate distinct cortical activity in PD with and without MCI.
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Affiliation(s)
- Jairo Alexander Carmona Arroyave
- Neuroscience Group, Medical School, University of Antioquia, SIU, Calle 62 No. 52–59, Medellín, Colombia
- Neuropsychology & Behavior Group (GRUNECO), Medical School, University of Antioquia, SIU – Área Asistencial, Calle 62 No. 52–59, Medellín, Colombia
| | - Carlos Andrés Tobón Quintero
- Neuroscience Group, Medical School, University of Antioquia, SIU, Calle 62 No. 52–59, Medellín, Colombia
- Neuropsychology & Behavior Group (GRUNECO), Medical School, University of Antioquia, SIU – Área Asistencial, Calle 62 No. 52–59, Medellín, Colombia
| | - Jasmín Jimena Suárez Revelo
- Neuroscience Group, Medical School, University of Antioquia, SIU, Calle 62 No. 52–59, Medellín, Colombia
- Bioinstrumentation & Clinical Engineering Research Group (GIBIC), Bioengineering Program, University of Antioquia, Calle 70 No. 52–21, Medellín, Colombia
| | - John Fredy Ochoa Gómez
- Neuroscience Group, Medical School, University of Antioquia, SIU, Calle 62 No. 52–59, Medellín, Colombia
- Bioinstrumentation & Clinical Engineering Research Group (GIBIC), Bioengineering Program, University of Antioquia, Calle 70 No. 52–21, Medellín, Colombia
| | - Yamile Bocanegra García
- Neuroscience Group, Medical School, University of Antioquia, SIU, Calle 62 No. 52–59, Medellín, Colombia
- Neuropsychology & Behavior Group (GRUNECO), Medical School, University of Antioquia, SIU – Área Asistencial, Calle 62 No. 52–59, Medellín, Colombia
| | - Leonardo Moreno Gómez
- Neurology Unit, Pablo Tobón Uribe Hospital, Calle 78B No. 69–240, Medellín, Colombia
| | - David Antonio Pineda Salazar
- Neuroscience Group, Medical School, University of Antioquia, SIU, Calle 62 No. 52–59, Medellín, Colombia
- Neuropsychology & Behavior Group (GRUNECO), Medical School, University of Antioquia, SIU – Área Asistencial, Calle 62 No. 52–59, Medellín, Colombia
- Neuropsychology & Behavior Group (GRUNECO), Psychology Department, University of San Buenaventura, Carrera 56 C No. 51–110, Medellín, Colombia
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10
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Bledsoe IO, Stebbins GT, Merkitch D, Goldman JG. White matter abnormalities in the corpus callosum with cognitive impairment in Parkinson disease. Neurology 2018; 91:e2244-e2255. [PMID: 30429273 DOI: 10.1212/wnl.0000000000006646] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 08/23/2018] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To evaluate microstructural characteristics of the corpus callosum using diffusion tensor imaging (DTI) and their relationships to cognitive impairment in Parkinson disease (PD). METHODS Seventy-five participants with PD and 24 healthy control (HC) participants underwent structural MRI brain scans including DTI sequences and clinical and neuropsychological evaluations. Using Movement Disorder Society criteria, PD participants were classified as having normal cognition (PD-NC, n = 23), mild cognitive impairment (PD-MCI, n = 35), or dementia (PDD, n = 17). Cognitive domain (attention/working memory, executive function, language, memory, visuospatial function) z scores were calculated. DTI scalar values, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD), were established for 5 callosal segments on a midsagittal plane, single slice using a topographically derived parcellation method. Scalar values were compared among participant groups. Regression analyses were performed on cognitive domain z scores and DTI metrics. RESULTS Participants with PD showed increased AD values in the anterior 3 callosal segments compared to healthy controls. Participants with PDD had significantly increased AD, MD, and RD in the anterior 2 segments compared to participants with PD-NC and most anterior segment compared to participants with PD-MCI. FA values did not differ significantly between participants with PD and participants with HC or among PD cognitive groups. The strongest associations for the DTI metrics and cognitive performance occurred in the most anterior and most posterior callosal segments, and also reflected fronto-striatal and posterior cortical type cognitive deficits, respectively. CONCLUSIONS Microstructural white matter abnormalities of the corpus callosum, as measured by DTI, may contribute to PD cognitive impairment by disrupting information transfer across interhemispheric and callosal-cortical projections.
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Affiliation(s)
- Ian O Bledsoe
- From the Movement Disorder and Neuromodulation Center (I.O.B.), Department of Neurology, University of California, San Francisco; and the Section of Parkinson Disease and Movement Disorders (G.T.S., D.M., J.G.G.), Department of Neurological Sciences, Rush University Medical Center, Chicago, IL
| | - Glenn T Stebbins
- From the Movement Disorder and Neuromodulation Center (I.O.B.), Department of Neurology, University of California, San Francisco; and the Section of Parkinson Disease and Movement Disorders (G.T.S., D.M., J.G.G.), Department of Neurological Sciences, Rush University Medical Center, Chicago, IL
| | - Doug Merkitch
- From the Movement Disorder and Neuromodulation Center (I.O.B.), Department of Neurology, University of California, San Francisco; and the Section of Parkinson Disease and Movement Disorders (G.T.S., D.M., J.G.G.), Department of Neurological Sciences, Rush University Medical Center, Chicago, IL
| | - Jennifer G Goldman
- From the Movement Disorder and Neuromodulation Center (I.O.B.), Department of Neurology, University of California, San Francisco; and the Section of Parkinson Disease and Movement Disorders (G.T.S., D.M., J.G.G.), Department of Neurological Sciences, Rush University Medical Center, Chicago, IL.
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11
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De Micco R, Russo A, Tessitore A. Structural MRI in Idiopathic Parkinson's Disease. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2018; 141:405-438. [PMID: 30314605 DOI: 10.1016/bs.irn.2018.08.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
Among modern neuroimaging modalities, magnetic resonance imaging (MRI) is a widely available, non-invasive, and cost-effective method to detect structural and functional abnormalities related to neurodegenerative disorders. In the last decades, MRI have been widely implemented to support PD diagnosis as well as to provide further insights into motor and non-motor symptoms pathophysiology, complications and treatment-related effects. Different aspects of the brain morphology and function may be derived from a single scan, by applying different analytic approaches. Biomarkers of neurodegeneration as well as tissue microstructural changes may be extracted from structural MRI techniques. In this chapter, we analyze the role of structural imaging to differentiate PD patients from controls and to define neural substrates of motor and non-motor PD symptoms. Evidence collected in the premotor PD phase will be also critically discussed. White matter as well as gray matter integrity imaging studies has been reviewed, aiming to highlight points of strength and limits to their potential application in clinical settings.
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Affiliation(s)
- Rosa De Micco
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy; MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Antonio Russo
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy; MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Alessandro Tessitore
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy; MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Napoli, Italy.
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12
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Ashraf-Ganjouei A, Majd A, Javinani A, Aarabi MH. Autonomic dysfunction and white matter microstructural changes in drug-naïve patients with Parkinson's disease. PeerJ 2018; 6:e5539. [PMID: 30225168 PMCID: PMC6139241 DOI: 10.7717/peerj.5539] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 08/08/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Autonomic dysfunction (AD) is one of the non-motor features of Parkinson's disease (PD). Some symptoms tend to occur in the early stages of PD. AD also has a great impact on patient's quality of life. In this study, we aimed to discover the association between AD (Scales for Outcomes in Parkinson's disease-Autonomic, SCOPA-AUT) and microstructural changes in white matter tracts in drug-naïve early PD patients to elucidate the central effects of autonomic nervous system impairments. METHOD In total, this study included 85 subjects with PD recruited from the Parkinson's Progression Markers Initiative (PPMI) database. Among the 85 PD patients, 38 were in Hoehn & Yahr stage 1 (HY1PD) and 47 were in stage 2 (HY2PD). Diffusion magnetic resonance imaging (DMRI) data were reconstructed in the MNI space using q-space diffeomorphic reconstruction to obtain the spin distribution function. The spin distribution function (SDF) values were used in DMRI connectometry analysis. We investigated through diffusion MRI connectometry the structural correlates of white matter tracts with SCOPA-AUT subscores and total score. RESULTS Connectometry analysis also revealed positive association with white matter density in bilateral corticospinal tract in HY1PD patients and negative association in genu of corpus callosum (CC) and, bilateral cingulum in both groups. In addition, there were associations between gastrointestinal, sexual, thermoregulatory and urinary items and structural brain connectivity in PD. CONCLUSION Our study reveals positive correlation, suggesting neural compensations in early PD. Cingulum and CC tracts have well-known roles in PD pathology, compatible with our findings that bring new insights to specific areas of AD and its role in central nervous system (CNS) neurodegeneration, paving the way for using prodromal makers in the diagnosis and treatment of PD.
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Affiliation(s)
| | - Alireza Majd
- Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Javinani
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
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13
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赵 茸, 王 天, 狄 政, 杨 军, 徐 敏, 刘 志, 朱 旭, 邬 小, 高 晓. [Voxel-based analysis of cerebral blood flow changes in Parkinson disease using arterial spin labeling technique]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2018; 38:117-122. [PMID: 33177029 PMCID: PMC6765609 DOI: 10.3969/j.issn.1673-4254.2018.01.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To explore the imaging biomarker for early diagnosis and disease course monitoring of Parkinson disease (PD) in arterial spin labeling (ASL) technique. METHODS Between July, 2014 and May, 2017, 23 patients with PD underwent magnetic resonance imaging (MRI) and ASL examinations in our hospital, including 13 in the early stage and 10 in advanced stages. Voxel-based analysis (VBA) was used to observe the regional cerebral blood flow (rCBF) characteristics in PD patients in different stages and three-dimensional continuous arterial spin labeling (3D CASL) was used to analyze the mean cerebral blood flow (mCBF). RESULTS No significant difference was found in mCBF among PD patients in the early stage, patients in advanced stages and normal control subjects (P=0.30). Compared with the normal control group, the patients with early-stage PD had decreased rCBF in resting state mainly in the right superior occipital gyrus and the right superior frontal gyrus as revealed by VBA (P < 0.001); the patients with advanced PD showed decreased rCBF mainly in the left precentral gyrus and the postcentral gyrus (P < 0.001). The patients with advanced PD exhibited lowered rCBF in the right substantia nigra and the bilateral corpus callosum as compared with the early-stage patients (P < 0.001). CONCLUSIONS VBA of ASL reveals rCBF alterations in association with the disease progression in PD patients, suggesting that this technique might provide assistance in identification of potential markers for early PD diagnosis and for monitoring the disease course.
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Affiliation(s)
- 茸 赵
- 西安交通大学医学院附属西安市中心医院 神经内科,陕西 西安 710003Department of Neurology, Xi'an Central Hospital Affiliated to Xi'an Jiaotong University College of Medicine, Xi'an 710003, China
| | - 天仲 王
- 西安交通大学医学院附属西安市中心医院 神经内科,陕西 西安 710003Department of Neurology, Xi'an Central Hospital Affiliated to Xi'an Jiaotong University College of Medicine, Xi'an 710003, China
- 延安大学医学院,陕西 延安 716000Medical College of Yan'an University, Yan'an 716000, China
| | - 政莉 狄
- 西安交通大学医学院附属西安市中心医院 神经内科,陕西 西安 710003Department of Neurology, Xi'an Central Hospital Affiliated to Xi'an Jiaotong University College of Medicine, Xi'an 710003, China
| | - 军乐 杨
- 西安交通大学医学院附属西安市中心医院 放射科,陕西 西安 710003Department of Radiology, Xi'an Central Hospital Affiliated to Xi'an Jiaotong University College of Medicine, Xi'an 710003, China
| | - 敏 徐
- 西安交通大学医学院附属西安市中心医院 放射科,陕西 西安 710003Department of Radiology, Xi'an Central Hospital Affiliated to Xi'an Jiaotong University College of Medicine, Xi'an 710003, China
| | - 志勤 刘
- 西安交通大学医学院附属西安市中心医院 神经内科,陕西 西安 710003Department of Neurology, Xi'an Central Hospital Affiliated to Xi'an Jiaotong University College of Medicine, Xi'an 710003, China
| | - 旭蓉 朱
- 西安交通大学医学院附属西安市中心医院 神经内科,陕西 西安 710003Department of Neurology, Xi'an Central Hospital Affiliated to Xi'an Jiaotong University College of Medicine, Xi'an 710003, China
- 延安大学医学院,陕西 延安 716000Medical College of Yan'an University, Yan'an 716000, China
| | - 小平 邬
- 西安交通大学医学院附属西安市中心医院 放射科,陕西 西安 710003Department of Radiology, Xi'an Central Hospital Affiliated to Xi'an Jiaotong University College of Medicine, Xi'an 710003, China
| | - 晓宇 高
- 西安交通大学医学院附属西安市中心医院 神经内科,陕西 西安 710003Department of Neurology, Xi'an Central Hospital Affiliated to Xi'an Jiaotong University College of Medicine, Xi'an 710003, China
- 延安大学医学院,陕西 延安 716000Medical College of Yan'an University, Yan'an 716000, China
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14
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Liu ZY, Liu FT, Zuo CT, Koprich JB, Wang J. Update on Molecular Imaging in Parkinson's Disease. Neurosci Bull 2017; 34:330-340. [PMID: 29282614 DOI: 10.1007/s12264-017-0202-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 11/04/2017] [Indexed: 12/14/2022] Open
Abstract
Advances in radionuclide tracers have allowed for more accurate imaging that reflects the actions of numerous neurotransmitters, energy metabolism utilization, inflammation, and pathological protein accumulation. All of these achievements in molecular brain imaging have broadened our understanding of brain function in Parkinson's disease (PD). The implementation of molecular imaging has supported more accurate PD diagnosis as well as assessment of therapeutic outcome and disease progression. Moreover, molecular imaging is well suited for the detection of preclinical or prodromal PD cases. Despite these advances, future frontiers of research in this area will focus on using multi-modalities combining positron emission tomography and magnetic resonance imaging along with causal modeling with complex algorithms.
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Affiliation(s)
- Zhen-Yang Liu
- Department of Neurology and National Clinical Research Center for Ageing and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Feng-Tao Liu
- Department of Neurology and National Clinical Research Center for Ageing and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China
| | - Chuan-Tao Zuo
- PET Center, Huashan Hospital, Fudan University, Shanghai, 200235, China
| | - James B Koprich
- Department of Neurology and National Clinical Research Center for Ageing and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China.,Krembil Institute, Toronto Western Hospital, University Health Network, Toronto, ON, M5T 2S8, Canada
| | - Jian Wang
- Department of Neurology and National Clinical Research Center for Ageing and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China.
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15
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Haghshomar M, Rahmani F, Hadi Aarabi M, Shahjouei S, Sobhani S, Rahmani M. White Matter Changes Correlates of Peripheral Neuroinflammation in Patients with Parkinson's Disease. Neuroscience 2017; 403:70-78. [PMID: 29126955 DOI: 10.1016/j.neuroscience.2017.10.050] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 10/29/2017] [Accepted: 10/31/2017] [Indexed: 12/23/2022]
Abstract
Neuroinflammatory pathology has long been identified to contribute to the pathology of Parkinson disease. Early microstructural changes in white matter tracts might give a clue for earlier detection of PD. We investigated through diffusion MRI connectometry the structural correlates of white matter tracts of 81 patients with PD with whole blood neutrophil-to-lymphocyte ratio (NLR), controlling for age and sex. Diffusion data were reconstructed in the MNI space using q-space diffeomorphic reconstruction to obtain the spin distribution function. The spin distribution function (SDF) values were used in DMRI connectometry analysis. The connectometry analyses identified white matter QA of the following fibers to be correlated with NLR score after adjustment for age and sex: bilateral cingulum, body and left crus of fornix, bilateral corticospinal tract (CST), and body and splenium of corpus callosum (CC) and superior cerebellar peduncle with decreased connectivity related to NLR (FDR = 0.04542). Keeping with emerging evidence on the role of neuroinflammation in PD pathology, these results with functional relevance to prodromal Parkinson disease, bring new insights to pivotal role of peripheral inflammation in CNS neurodegeneration.
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Affiliation(s)
- Maryam Haghshomar
- NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Rahmani
- NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mohammad Hadi Aarabi
- NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shima Shahjouei
- NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Department of Neurology, Tehran University of Medical Sciences, Tehran, Iran
| | - Soheila Sobhani
- NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Rahmani
- NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Endocrine Research Center (ERC), Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran
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16
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de Oliveira RV, Pereira JS. The role of diffusion magnetic resonance imaging in Parkinson's disease and in the differential diagnosis with atypical parkinsonism. Radiol Bras 2017; 50:250-257. [PMID: 28894333 PMCID: PMC5586516 DOI: 10.1590/0100-3984.2016-0073] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
Parkinson's disease is one of the most common neurodegenerative diseases.
Clinically, it is characterized by motor symptoms. Parkinson's disease should be
differentiated from atypical parkinsonism conditions. Conventional magnetic
resonance imaging is the primary imaging method employed in order to facilitate
the differential diagnosis, and its role has grown after the development of
advanced techniques such as diffusion-weighted imaging. The purpose of this
article was to review the role of magnetic resonance imaging in Parkinson's
disease and in the differential diagnosis with atypical parkinsonism,
emphasizing the diffusion technique.
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Affiliation(s)
- Romulo Varella de Oliveira
- Full Member of the Colégio Brasileiro de Radiologia e Diagnóstico por Imagem (CBR), Masters Student in the Graduate Program in Medical Sciences at the Faculdade de Ciências Médicas da Universidade do Estado do Rio de Janeiro (FCM-UERJ), MD, Radiologist at the Hospital Universitário Pedro Ernesto (HUPE) and at the Clínica Alta Excelência Diagnóstica (DASA), Rio de Janeiro, RJ, Brazil
| | - João Santos Pereira
- PhD, Full Member of the Academia Brasileira de Neurologia (ABN), Associate Professor, Coordinator of the Movement Disorders Sector of the Neurology Department of the Hospital Universitário Pedro Ernesto da Universidade do Estado do Rio de Janeiro (HUPE-UERJ), Rio de Janeiro, RJ, Brazil
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17
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Atkinson-Clement C, Pinto S, Eusebio A, Coulon O. Diffusion tensor imaging in Parkinson's disease: Review and meta-analysis. Neuroimage Clin 2017; 16:98-110. [PMID: 28765809 PMCID: PMC5527156 DOI: 10.1016/j.nicl.2017.07.011] [Citation(s) in RCA: 152] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 07/13/2017] [Accepted: 07/14/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Neuroimaging studies help us better understand the pathophysiology and symptoms of Parkinson's disease (PD). In several of these studies, diffusion tensor imaging (DTI) was used to investigate structural changes in cerebral tissue. Although data have been provided as regards to specific brain areas, a whole brain meta-analysis is still missing. METHODS We compiled 39 studies in this meta-analysis: 14 used fractional anisotropy (FA), 1 used mean diffusivity (MD), and 24 used both indicators. These studies comprised 1855 individuals, 1087 with PD and 768 healthy controls. Regions of interest were classified anatomically (subcortical structures; white matter; cortical areas; cerebellum). Our statistical analysis considered the disease effect size (DES) as the main variable; the heterogeneity index (I2) and Pearson's correlations between the DES and co-variables (demographic, clinical and MRI parameters) were also calculated. RESULTS Our results showed that FA-DES and MD-DES were able to distinguish between patients and healthy controls. Significant differences, indicating degenerations, were observed within the substantia nigra, the corpus callosum, and the cingulate and temporal cortices. Moreover, some findings (particularly in the corticospinal tract) suggested opposite brain changes associated with PD. In addition, our results demonstrated that MD-DES was particularly sensitive to clinical and MRI parameters, such as the number of DTI directions and the echo time within white matter. CONCLUSIONS Despite some limitations, DTI appears as a sensitive method to study PD pathophysiology and severity. The association of DTI with other MRI methods should also be considered and could benefit the study of brain degenerations in PD.
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Affiliation(s)
| | - Serge Pinto
- Aix Marseille Univ, CNRS, LPL, Aix-en-Provence, France
- Brain and Language Research Institute, Aix Marseille Univ, Aix-en-Provence, France
| | - Alexandre Eusebio
- Aix Marseille Univ, APHM, Hôpital de la Timone, Service de Neurologie et Pathologie du Mouvement, Marseille, France
- Aix Marseille Univ, CNRS, INT, Inst Neurosci Timone, Marseille France
| | - Olivier Coulon
- Brain and Language Research Institute, Aix Marseille Univ, Aix-en-Provence, France
- Aix Marseille Univ, CNRS, INT, Inst Neurosci Timone, Marseille France
- Aix Marseille Univ, CNRS, LSIS lab, UMR 7296, Marseille, France
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18
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Hall JM, Ehgoetz Martens KA, Walton CC, O'Callaghan C, Keller PE, Lewis SJG, Moustafa AA. Diffusion alterations associated with Parkinson's disease symptomatology: A review of the literature. Parkinsonism Relat Disord 2016; 33:12-26. [PMID: 27765426 DOI: 10.1016/j.parkreldis.2016.09.026] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 07/28/2016] [Accepted: 09/26/2016] [Indexed: 01/06/2023]
Abstract
Parkinson's disease (PD) is a heterogeneous neurological disorder with a variety of motor and non-motor symptoms. The underlying mechanisms of these symptoms are not fully understood. An increased interest in structural connectivity analyses using diffusion tensor imaging (DTI) in PD has led to an expansion of our understanding of the impact of abnormalities in diffusivity on phenotype. This review outlines the contribution of these abnormalities to symptoms of PD including bradykinesia, tremor and non-tremor phenotypes, freezing of gait, cognitive impairment, mood, sleep disturbances, visual hallucinations and olfactory dysfunction. Studies have shown that impairments in cognitive functioning are related to diffusion abnormalities in frontal and parietal regions, as well as in the corpus callosum and major fibres connecting midbrain and subcortical structures with the neocortex. However, the impact of diffusion alterations on motor, mood and other symptoms of PD are less well understood. The findings presented here highlight the challenges faced and the potential areas of future research avenues where DTI may be beneficial. Larger cohort studies and standardized imaging protocols are required to investigate current promising preliminary findings.
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Affiliation(s)
- Julie M Hall
- Brain and Mind Centre, University of Sydney, Sydney, Australia; School of Social Sciences and Psychology, Western Sydney University, Sydney, Australia
| | | | | | - Claire O'Callaghan
- Brain and Mind Centre, University of Sydney, Sydney, Australia; Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom; Department of Psychology, University of Cambridge, Cambridge, UK
| | - Peter E Keller
- MARCS Institute, Western Sydney University, Sydney, Australia
| | - Simon J G Lewis
- Brain and Mind Centre, University of Sydney, Sydney, Australia.
| | - Ahmed A Moustafa
- School of Social Sciences and Psychology, Western Sydney University, Sydney, Australia; MARCS Institute, Western Sydney University, Sydney, Australia
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19
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Conventional 3T brain MRI and diffusion tensor imaging in the diagnostic workup of early stage parkinsonism. Neuroradiology 2015; 57:655-69. [PMID: 25845807 PMCID: PMC4495265 DOI: 10.1007/s00234-015-1515-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 03/13/2015] [Indexed: 11/17/2022]
Abstract
Introduction The aim of this study is to evaluate whether the diagnostic accuracy of 3 T brain MRI is improved by region of interest (ROI) measures of diffusion tensor imaging (DTI), to differentiate between neurodegenerative atypical parkinsonism (AP) and Parkinson’s disease (PD) in early stage parkinsonism. Methods We performed a prospective observational cohort study of 60 patients presenting with early stage parkinsonism and initial uncertain diagnosis. At baseline, patients underwent a 3 T brain MRI including DTI. After clinical follow-up (mean 28.3 months), diagnoses could be made in 49 patients (30 PD and 19 AP). Conventional brain MRI was evaluated for regions of atrophy and signal intensity changes. Tract-based spatial statistics and ROI analyses of DTI were performed to analyze group differences in mean diffusivity (MD) and fractional anisotropy (FA), and diagnostic thresholds were determined. Diagnostic accuracy of conventional brain MRI and DTI was assessed with the receiver operating characteristic (ROC). Results Significantly higher MD of the centrum semiovale, body corpus callosum, putamen, external capsule, midbrain, superior cerebellum, and superior cerebellar peduncles was found in AP. Significantly increased MD of the putamen was found in multiple system atrophy–parkinsonian form (MSA-P) and increased MD in the midbrain and superior cerebellar peduncles in progressive supranuclear palsy (PSP). The diagnostic accuracy of brain MRI to identify AP as a group was not improved by ROI measures of MD, though the diagnostic accuracy to identify MSA-P was slightly increased (AUC 0.82 to 0.85). Conclusion The diagnostic accuracy of brain MRI to identify AP as a group was not improved by the current analysis approach to DTI, though DTI measures could be of added value to identify AP subgroups.
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Kanchibhotla SC, Mather KA, Thalamuthu A, Zhuang L, Schofield PR, Kwok JBJ, Ames D, Wright MJ, Trollor JN, Wen W, Sachdev PS. Genetics of microstructure of the corpus callosum in older adults. PLoS One 2014; 9:e113181. [PMID: 25514436 PMCID: PMC4267776 DOI: 10.1371/journal.pone.0113181] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 10/21/2014] [Indexed: 02/02/2023] Open
Abstract
The current study sought to examine the relative influence of genetic and environmental factors on corpus callosum (CC) microstructure in a community sample of older adult twins. Analyses were undertaken in 284 healthy older twins (66% female; 79 MZ and 63 DZ pairs) from the Older Australian Twins Study. The average age of the sample was 69.82 (SD = 4.76) years. Brain imaging scans were collected and DTI measures were estimated for the whole CC as well as its five subregions. Parcellation of the CC was performed using Analyze. In addition, white matter lesion (WMLs) burden was estimated. Heritability and genetic correlation analyses were undertaken using the SOLAR software package. Age, sex, scanner, handedness and blood pressure were considered as covariates. Heritability (h2) analysis for the DTI metrics of whole CC, indicated significant h2 for fractional anisotropy (FA) (h2 = 0.56; p = 2.89×10−10), mean diffusivity (MD) (h2 = 0.52; p = 0.30×10−6), radial diffusivity (RD) (h2 = 0.49; p = 0.2×10−6) and axial diffusivity (AD) (h2 = 0.37; p = 8.15×10−5). We also performed bivariate genetic correlation analyses between (i) whole CC DTI measures and (ii) whole CC DTI measures with total brain WML burden. Across the DTI measures for the whole CC, MD and RD shared 84% of the common genetic variance, followed by MD- AD (77%), FA - RD (52%), RD - AD (37%) and FA – MD (11%). For total WMLs, significant genetic correlations indicated that there was 19% shared common genetic variance with whole CC MD, followed by CC RD (17%), CC AD (16%) and CC FA (5%). Our findings suggest that the CC microstructure is under moderate genetic control. There was also evidence of shared genetic factors between the CC DTI measures. In contrast, there was less shared genetic variance between WMLs and the CC DTI metrics, suggesting fewer common genetic variants.
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Affiliation(s)
- Sri C. Kanchibhotla
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Karen A. Mather
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Anbupalam Thalamuthu
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Lin Zhuang
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Peter R. Schofield
- Neuroscience Research Australia, Sydney, Australia
- School of Medical Science, University of New South Wales, Sydney, Australia
| | - John B. J. Kwok
- Neuroscience Research Australia, Sydney, Australia
- School of Medical Science, University of New South Wales, Sydney, Australia
| | - David Ames
- National Ageing Research Institute, Royal Melbourne Hospital, Melbourne, Australia
- Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne, Australia
| | - Margaret J. Wright
- Queensland Institute Medical Research, Berghofer Medical Research Institute, Brisbane, Australia
| | - Julian N. Trollor
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
- Department Developmental Disability Neuropsychiatry, University of New South Wales, Sydney, Australia
| | - Wei Wen
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
- Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, Australia
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
- Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, Australia
- * E-mail:
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Kong Y, Wang D, Shi L, Hui SCN, Chu WCW. Adaptive distance metric learning for diffusion tensor image segmentation. PLoS One 2014; 9:e92069. [PMID: 24651858 PMCID: PMC3961296 DOI: 10.1371/journal.pone.0092069] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 02/17/2014] [Indexed: 11/23/2022] Open
Abstract
High quality segmentation of diffusion tensor images (DTI) is of key interest in biomedical research and clinical application. In previous studies, most efforts have been made to construct predefined metrics for different DTI segmentation tasks. These methods require adequate prior knowledge and tuning parameters. To overcome these disadvantages, we proposed to automatically learn an adaptive distance metric by a graph based semi-supervised learning model for DTI segmentation. An original discriminative distance vector was first formulated by combining both geometry and orientation distances derived from diffusion tensors. The kernel metric over the original distance and labels of all voxels were then simultaneously optimized in a graph based semi-supervised learning approach. Finally, the optimization task was efficiently solved with an iterative gradient descent method to achieve the optimal solution. With our approach, an adaptive distance metric could be available for each specific segmentation task. Experiments on synthetic and real brain DTI datasets were performed to demonstrate the effectiveness and robustness of the proposed distance metric learning approach. The performance of our approach was compared with three classical metrics in the graph based semi-supervised learning framework.
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Affiliation(s)
- Youyong Kong
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
- Research Center for Medical Image Computing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Defeng Wang
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
- Research Center for Medical Image Computing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
- The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, China
- Department of Biomedical Engineering and Shun Hing Institute of Advanced Engineering, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
- * E-mail: (DW); (WCWC)
| | - Lin Shi
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
- Research Center for Medical Image Computing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Steve C. N. Hui
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
- Research Center for Medical Image Computing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
| | - Winnie C. W. Chu
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
- Research Center for Medical Image Computing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
- The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, China
- * E-mail: (DW); (WCWC)
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Lee DH, Park JW, Hong CP. Quantitative volumetric analysis of the optic radiation in the normal human brain using diffusion tensor magnetic resonance imaging-based tractography. Neural Regen Res 2014; 9:280-4. [PMID: 25206813 PMCID: PMC4146140 DOI: 10.4103/1673-5374.128223] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2013] [Indexed: 11/29/2022] Open
Abstract
To attain the volumetric information of the optic radiation in normal human brains, we performed diffusion tensor imaging examination in 13 healthy volunteers. Simultaneously, we used a brain normalization method to reduce individual brain variation and increase the accuracy of volumetric information analysis. In addition, tractography-based group mapping method was also used to investigate the probability and distribution of the optic radiation pathways. Our results showed that the measured optic radiation fiber tract volume was a range of about 0.16% and that the fractional anisotropy value was about 0.53. Moreover, the optic radiation probability fiber pathway that was determined with diffusion tensor tractography-based group mapping was able to detect the location relatively accurately. We believe that our methods and results are helpful in the study of optic radiation fiber tract information.
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Affiliation(s)
- Dong-Hoon Lee
- Center for Medical Metrology, Division of Convergence Technology, Korea Research Institute of Standards and Science (KRISS), Daejeon, Republic of Korea ; Department of Radiological Science, College of Health Science, Yonsei University, Wonju, Republic of Korea
| | - Ji-Won Park
- Department of Physical Therapy, College of Medical Science, Catholic University of Daegu, Daegu, Republic of Korea
| | - Cheol-Pyo Hong
- Center for Medical Metrology, Division of Convergence Technology, Korea Research Institute of Standards and Science (KRISS), Daejeon, Republic of Korea
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Perea RD, Rada RC, Wilson J, Vidoni ED, Morris JK, Lyons KE, Pahwa R, Burns JM, Honea RA. A Comparative White Matter Study with Parkinson's disease, Parkinson's Disease with Dementia and Alzheimer's Disease. JOURNAL OF ALZHEIMER'S DISEASE & PARKINSONISM 2013; 3:123. [PMID: 24724042 PMCID: PMC3979316 DOI: 10.4172/2161-0460.1000123] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Alzheimer's disease (AD) and Parkinson's disease (PD) are among the most common neurodegenerative disorders affecting older populations. AD is characterized by impaired memory and cognitive decline while the primary symptoms of PD include resting tremor, bradykinesia and rigidity. In PD, mild cognitive changes are frequently present, which could progress to dementia (PD dementia (PDD)). PDD and AD dementias are different in pathology although the difference in microstructural changes remains unknown. To further understand these diseases, it is essential to understand the distinct mechanism of their microstructural changes. We used diffusion tensor imaging (DTI) to investigate white matter tract differences between early stage individuals with AD (n=14), PD (n=12), PDD (n=9), and healthy non-demented controls (CON) (n=13). We used whole brain tract based spatial statistics (TBSS) and a region of interest (ROI) analysis focused on the substantia nigra (SN). We found that individuals with PDD had more widespread white matter degeneration compared to PD, AD, and CON. Individuals with AD had few regional abnormalities in the anterior and posterior projections of the corpus callosum while PD and CON did not appear to have significant white matter degeneration when compared to other groups. ROI analyses showed that PDD had the highest diffusivity in the SN and were significantly different from CON. There were no significant ROI differences between CON, PD, or AD. In conclusion, global white matter microstructural deterioration is evident in individuals with PDD, and DTI may provide a means with which to tease out pathological differences between AD and PD dementias.
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Affiliation(s)
- Rodrigo D Perea
- Department of Neurology, University of Kansas School of Medicine, Kansas City, KS, USA
- Alzheimer's Research Disease Center, University of Kansas School of Medicine, Kansas City, KS, USA
- Bioengineering Program, Department of Engineering, University of Kansas, Lawrence, KS, USA
| | - Rebecca C Rada
- Alzheimer's Research Disease Center, University of Kansas School of Medicine, Kansas City, KS, USA
| | - Jessica Wilson
- Department of Psychology, University of Kansas, Lawrence, KS, USA
| | - Eric D Vidoni
- Department of Neurology, University of Kansas School of Medicine, Kansas City, KS, USA
- Alzheimer's Research Disease Center, University of Kansas School of Medicine, Kansas City, KS, USA
| | - Jill K Morris
- Department of Neurology, University of Kansas School of Medicine, Kansas City, KS, USA
- Alzheimer's Research Disease Center, University of Kansas School of Medicine, Kansas City, KS, USA
| | - Kelly E Lyons
- Department of Neurology, University of Kansas School of Medicine, Kansas City, KS, USA
| | - Rajesh Pahwa
- Department of Neurology, University of Kansas School of Medicine, Kansas City, KS, USA
| | - Jeffrey M Burns
- Department of Neurology, University of Kansas School of Medicine, Kansas City, KS, USA
- Alzheimer's Research Disease Center, University of Kansas School of Medicine, Kansas City, KS, USA
| | - Robyn A Honea
- Department of Neurology, University of Kansas School of Medicine, Kansas City, KS, USA
- Alzheimer's Research Disease Center, University of Kansas School of Medicine, Kansas City, KS, USA
- Bioengineering Program, Department of Engineering, University of Kansas, Lawrence, KS, USA
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Diffusional kurtosis imaging of cingulate fibers in Parkinson disease: comparison with conventional diffusion tensor imaging. Magn Reson Imaging 2013; 31:1501-6. [PMID: 23895870 DOI: 10.1016/j.mri.2013.06.009] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 06/17/2013] [Accepted: 06/22/2013] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The pathological changes in Parkinson disease begin in the brainstem; reach the limbic system and ultimately spread to the cerebral cortex. In Parkinson disease (PD) patients, we evaluated the alteration of cingulate fibers, which comprise part of the limbic system, by using diffusional kurtosis imaging (DKI). METHODS Seventeen patients with PD and 15 age-matched healthy controls underwent DKI with a 3-T MR imager. Diffusion tensor tractography images of the anterior and posterior cingulum were generated. The mean kurtosis (MK) and conventional diffusion tensor parameters measured along the images in the anterior and posterior cingulum were compared between the groups. Receiver operating characteristic (ROC) analysis was also performed to compare the diagnostic abilities of the MK and conventional diffusion tensor parameters. RESULTS The MK and fractional anisotropy (FA) in the anterior cingulum were significantly lower in PD patients than in healthy controls. The area under the ROC curve was 0.912 for MK and 0.747 for FA in the anterior cingulum. MK in the anterior cingulum had the best diagnostic performance (mean cutoff, 0.967; sensitivity, 0.87; specificity, 0.94). CONCLUSIONS DKI can detect alterations of the anterior cingulum in PD patients more sensitively than can conventional diffusion tensor imaging. Use of DKI can be expected to improve the ability to diagnose PD.
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25
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Meijer FJA, Bloem BR, Mahlknecht P, Seppi K, Goraj B. Update on diffusion MRI in Parkinson's disease and atypical parkinsonism. J Neurol Sci 2013; 332:21-9. [PMID: 23866820 DOI: 10.1016/j.jns.2013.06.032] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 06/24/2013] [Accepted: 06/27/2013] [Indexed: 11/25/2022]
Abstract
Differentiating Parkinson's disease (PD) from other types of neurodegenerative atypical parkinsonism (AP) can be challenging, especially in early disease stages. Routine brain magnetic resonance imaging (MRI) can show atrophy or signal changes in several parts of the brain with fairly high specificity for particular forms of AP, but the overall diagnostic value of routine brain MRI is limited. In recent years, various advanced MRI sequences have become available, including diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI). Here, we review available literature on the value of diffusion MRI for identifying and quantifying different patterns of neurodegeneration in PD and AP, in relation to what is known of underlying histopathologic changes and clinical presentation of these diseases. Next, we evaluate the value of diffusion MRI to differentiate between PD and AP and the potential value of serial diffusion MRI to monitor disease progression. We conclude that diffusion MRI may quantify patterns of neurodegeneration which could be of additional value in clinical use. Future prospective clinical cohort studies are warranted to assess the added diagnostic value of diffusion MRI.
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Affiliation(s)
- Frederick J A Meijer
- Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen, The Netherlands.
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26
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Cochrane CJ, Ebmeier KP. Diffusion tensor imaging in parkinsonian syndromes: a systematic review and meta-analysis. Neurology 2013; 80:857-64. [PMID: 23439701 DOI: 10.1212/wnl.0b013e318284070c] [Citation(s) in RCA: 172] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES We performed a systematic review to assess alterations in measures of diffusion tensor imaging (DTI) in parkinsonian syndromes, exploring the potential role of DTI in diagnosis and as a candidate biomarker. METHODS We searched EMBASE and Medline databases for DTI studies comparing parkinsonian syndromes or related dementias with controls or another defined parkinsonian syndrome. Key details for each study regarding participants, imaging methods, and results were extracted. Estimates were pooled, where appropriate, by random-effects meta-analysis. RESULTS Of 333 results, we identified 43 studies suitable for inclusion (958 patients, 764 controls). DTI measures detected alterations in all parkinsonian syndromes, with distribution varying differentially with disease type. Nine studies were included in a meta-analysis of the substantia nigra in Parkinson disease. A notable effect size was found for lowered fractional anisotropy in the substantia nigra for patients with Parkinson disease vs controls (-0.639, 95% confidence interval -0.860 to -0.417, p < 0.0001). CONCLUSION DTI may be a promising biomarker in parkinsonian syndromes and have a future role in differential diagnosis. Larger cohort studies are required to investigate some encouraging preliminary findings. Given the complexity of the parkinsonian syndromes, it is likely that any potential DTI biomarker would be used in combination with other relevant biomarkers.
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Affiliation(s)
- Claire J Cochrane
- Division of Clinical Neurology and Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, UK.
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27
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Zheng Z, Shemmassian S, Wijekoon C, Kim W, Bookheimer SY, Pouratian N. DTI correlates of distinct cognitive impairments in Parkinson's disease. Hum Brain Mapp 2013; 35:1325-33. [PMID: 23417856 DOI: 10.1002/hbm.22256] [Citation(s) in RCA: 125] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Revised: 12/06/2012] [Accepted: 12/12/2012] [Indexed: 11/10/2022] Open
Abstract
The spectrum of cognitive symptoms in Parkinson's disease (PD) can span various domains, including executive function, language, attention, memory, and visuospatial skills. These symptoms may be attributable to the degradation of projection fibers associated with the underlying neurodegenerative process. The primary purpose of this study is to find microstructural correlates of impairments across these cognitive domains in PD using diffusion tensor imaging (DTI). Sixteen patients with PD with comprehensive neuropsychological evaluation and DTI data were retrospectively studied. Fractional anisotropy (FA) and mean diffusivity (MD) were assessed using regions-of-interest (ROI) analysis and confirmed with a voxel-based approach. Executive function directly correlated with FA and inversely correlated with MD in mostly frontal white matter tracts, especially the anterior limb of the internal capsule and genu of the corpus callosum. Likewise, language and attentional performance demonstrated correlations with DTI parameters in the frontal regions, but the attention domain additionally recruited regions widespread throughout the brain, with the most significant correlation identified in cingulate gyrus (cingulum). Lastly, memory impairment mainly involved MD alterations within the fornix. No significant correlations were found between visuospatial skills and DTI measures. Despite some overlap, unique patterns of white matter diffusivity underlie impairments in distinct cognitive domains in patients with PD. DTI combined with neurocognitive tests may be a valuable biomarker for identifying cognitive impairments in PD.
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Affiliation(s)
- Zhong Zheng
- Department of Neurosurgery, David Geffen School of Medicine at UCLA, Los Angeles, California
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Kamagata K, Motoi Y, Tomiyama H, Abe O, Ito K, Shimoji K, Suzuki M, Hori M, Nakanishi A, Sano T, Kuwatsuru R, Sasai K, Aoki S, Hattori N. Relationship between cognitive impairment and white-matter alteration in Parkinson's disease with dementia: tract-based spatial statistics and tract-specific analysis. Eur Radiol 2013; 23:1946-55. [PMID: 23404139 PMCID: PMC3674338 DOI: 10.1007/s00330-013-2775-4] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 12/04/2012] [Accepted: 12/20/2012] [Indexed: 11/24/2022]
Abstract
Objectives We investigated the relationship between white-matter alteration and cognitive status in Parkinson’s disease (PD) with and without dementia by using diffusion tensor imaging. Methods Twenty PD patients, 20 PDD (Parkinson’s disease with dementia) patients and 20 age-matched healthy controls underwent diffusion tensor imaging. The mean diffusivity and fractional anisotropy (FA) map of each patient group were compared with those of the control group by using tract-based spatial statistics. Tractography images of the genu of the corpus callosum fibre tracts were generated, and mean diffusivity and FA were measured. Results FA values in many major tracts were significantly lower in PDD patients than in control subjects; in the prefrontal white matter and the genu of the corpus callosum they were significantly lower in PDD patients than in PD patients. There was a significant correlation between the Mini-Mental State Examination (MMSE) scores and the FA values of the prefrontal white matter and the genu of the corpus callosum in patients with PD. Conclusions Our study shows a relationship between cognitive impairment and alteration of the prefrontal white matter and genu of the corpus callosum. These changes may be useful in assessing the onset of dementia in PD patients. Key Points • Dementia is a common and important non-motor sign of Parkinson’s disease (PD). • The neuropathological basis of dementia in PD is not clear. • DTI shows abnormalities in the prefrontal white matter in PD with dementia. • Prefrontal white matter alteration may be useful biomarker of dementia in PD.
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Affiliation(s)
- Koji Kamagata
- Department of Radiology, Juntendo University School of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
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Frederiksen KS, Waldemar G. Corpus callosum in aging and neurodegenerative diseases. Neurodegener Dis Manag 2012. [DOI: 10.2217/nmt.12.52] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
SUMMARY The corpus callosum (CC) is a major white matter bundle that connects primarily homologous areas of the cortex. The structure may be involved in interhemispheric communication and enable the lateralization of certain cerebral functions. Despite its possible role as the main conduit for interhemispheric communication, interest from researchers has, at times, been sparse. Renewed interest has led to research that has shown that the CC may play a role in both cognitive aging and neurodegenerative diseases including Alzheimer´s disease and frontotemporal dementia. Studies employing structural MRI and diffusion-weighted MRI have found distinct subregional patterns of callosal atrophy in aging, Alzheimer´s disease and frontotemporal dementia. Furthermore, imaging studies may help to elucidate the underlying pathological mechanisms of callosal atrophy. The present review aims to provide an overview of the current knowledge of the structure and function of the CC and its role in aging and neurodegenerative disease.
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Affiliation(s)
- Kristian Steen Frederiksen
- Memory Disorders Research Group, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
| | - Gunhild Waldemar
- Memory Disorders Research Group, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark
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Surdhar I, Gee M, Bouchard T, Coupland N, Malykhin N, Camicioli R. Intact limbic-prefrontal connections and reduced amygdala volumes in Parkinson's disease with mild depressive symptoms. Parkinsonism Relat Disord 2012; 18:809-13. [PMID: 22652466 DOI: 10.1016/j.parkreldis.2012.03.008] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2011] [Revised: 03/05/2012] [Accepted: 03/08/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND Depression is very common in Parkinson's disease (PD). The neuropathological basis for this remains unclear; however, dysfunction in prefrontal and limbic regions may play a role. METHODS We examined non-demented PD patients with and without depression and healthy controls (n = 6 per group) for differences in limbic structures and connections between these structures and the prefrontal cortex. Depressed individuals were selected from a representative sample of 33 PD patients using scores from the 15 question geriatric depression scale (GDS). Magnetic resonance diffusion tensor imaging (DTI) tractography was used to examine the structural integrity of the uncinate fasciculus (UF), a white matter tract that projects from the hippocampus, amygdala and temporal pole to the orbitofrontal cortex, and the corpus callosum. Integrity of the UF and corpus callosum was established through measures of mean diffusivity (MD), fractional anisotropy (FA) and tract length. A volumetric analysis of the hippocampal head, body and tail, as well as the amygdala was performed to determine whether volume differences in these structures in PD relate to depression. RESULTS The depressed PD group showed smaller amygdala volumes compared to healthy controls, but the groups did not differ on any other measure. CONCLUSIONS The present study found intact limbic connectivity but suggests that amygdala atrophy may be present in Parkinson's disease with depression. Further work is needed to replicate these findings.
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Affiliation(s)
- Ian Surdhar
- Centre for Neuroscience, University of Alberta, Edmonton, Canada
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Petrou M, Kotagal V, Bohnen NI. An update on brain imaging in parkinsonian dementia. ACTA ACUST UNITED AC 2012; 4:201-213. [PMID: 22768021 DOI: 10.2217/iim.12.10] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Disturbances of cognition are frequent in Parkinson's disease (PD). Unlike severe loss of dopamine early in PD, extensive cholinergic losses have been consistently reported in PD with dementia. Cholinergic imaging suggests that basal forebrain cholinergic system degeneration appears early in PD and worsens with dementia development. Cortical cholinergic denervation is similar in PD with dementia and dementia with Lewy bodies, supporting a common disease spectrum, at least with respect to cholinergic pathology. Presence of cerebral amyloidopathy in the setting of parkinsonism may accelerate cognitive decline. Novel MRI techniques illustrate the widespread presence of neurodegeneration in PD with dementia, affecting white matter tracts and connectivity functions. This review will outline current concepts regarding dementia development in PD and discuss their correlation with functional and structural neuroimaging including PET and MRI.
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He D, Wu Q, Chen X, Zhao D, Gong Q, Zhou H. Cognitive impairment and whole brain diffusion in patients with neuromyelitis optica after acute relapse. Brain Cogn 2011; 77:80-8. [PMID: 21723024 DOI: 10.1016/j.bandc.2011.05.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2010] [Revised: 05/23/2011] [Accepted: 05/27/2011] [Indexed: 02/05/2023]
Abstract
The objective of this study investigated cognitive impairments and their correlations with fractional anisotropy (FA) and mean diffusivity (MD) in patients with neuromyelitis optica (NMO) without visible lesions on conventional brain MRI during acute relapse. Twenty one patients with NMO and 21 normal control subjects received several cognitive tests to assess cognitive function. Head diffusion tensor imaging (DTI) of all patients with NMO were collected with a 3-T MR system. Correlations of cognitive test scores and whole brain FA and MD were examined by voxel-based analysis. Region-of-interest analysis was applied to the significantly correlated regions which the most frequently appeared. We found that NMO patients without visible brain lesions had significantly impaired learning and memory, decreased information processing speed, and damaged attention compared with normal control subjects. These impaired cognitive domains were significantly correlated with FA and MD in local regions of corpus callosum, anterior cingulate and medial frontal cortex. In corpus callosum of NMO patients, mean FA was significantly lower and mean MD higher than normal control subjects. Our findings suggest that cognitive impairments in learning and memory, information processing speed and attention occur in NMO patients without visible brain lesions during acute relapse. The impairments in immediate and short-term memory in NMO patients may be due to information encoding deficits in the process of information acquisition. The corpus callosum of such patients may have local microscopic damages that play a role in cognitive impairments during acute relapse.
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Affiliation(s)
- Dian He
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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