Subcortical atrophy and perfusion patterns in Parkinson disease and multiple system atrophy.
Aged
Atrophy
/ pathology
Basal Ganglia
/ diagnostic imaging
Cerebellum
/ diagnostic imaging
Cerebrovascular Circulation
/ physiology
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Multiple System Atrophy
/ diagnostic imaging
Neuroimaging
/ methods
Parkinson Disease
/ diagnostic imaging
Spin Labels
Arterial spin labeling
Cerebellum
Magnetic resonance imaging
Multiple system atrophy
Parkinson disease
Journal
Parkinsonism & related disorders
ISSN: 1873-5126
Titre abrégé: Parkinsonism Relat Disord
Pays: England
ID NLM: 9513583
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
08
08
2019
revised:
17
02
2020
accepted:
20
02
2020
pubmed:
29
2
2020
medline:
30
1
2021
entrez:
29
2
2020
Statut:
ppublish
Résumé
The clinical differentiation between Parkinson disease (PD) and multiple system atrophy (MSA) is difficult. Arterial spin labeling (ASL) is an advanced MRI technique that obviates the use of an exogenous contrast agent for the estimation of cerebral perfusion. We explored the value of ASL in combination with structural MRI for the differentiation between PD and MSA. Ninety-four subjects (30 PD, 30 MSA and 34 healthy controls) performed a morphometric and ASL-MRI to measure volume and perfusion values within basal ganglia and cerebellum. A region-of-interest analysis was performed to test for structural atrophy and regional blood flow differences between groups. MSA patients showed higher subcortical atrophy than both PD patients and HC, while no differences were observed between the latter. MSA and PD showed lower volume-corrected perfusion values than HC in several cerebellar areas (Crus I, Crus II, right VIIb, right VIIIa, right VIIIb), right caudate and both thalami. MSA and PD patients displayed similar perfusion values in all aforementioned areas, but the right cerebellar area VIIIb (lower in MSA) and right caudate and both thalami (lower in PD). Similar results were obtained when comparing PD and MSA patients with the parkinsonian variant. A perfusion reduction was equally observed in both MSA and PD patients in cerebellar areas that are putatively linked to cognitive (i.e., executive) rather than motor functions. The observed hypo-perfusion could not be explained by atrophy, suggesting the involvement of the cerebellum in the pathophysiology of both MSA and PD.
Sections du résumé
BACKGROUND
The clinical differentiation between Parkinson disease (PD) and multiple system atrophy (MSA) is difficult.
OBJECTIVES
Arterial spin labeling (ASL) is an advanced MRI technique that obviates the use of an exogenous contrast agent for the estimation of cerebral perfusion. We explored the value of ASL in combination with structural MRI for the differentiation between PD and MSA.
METHODS
Ninety-four subjects (30 PD, 30 MSA and 34 healthy controls) performed a morphometric and ASL-MRI to measure volume and perfusion values within basal ganglia and cerebellum. A region-of-interest analysis was performed to test for structural atrophy and regional blood flow differences between groups.
RESULTS
MSA patients showed higher subcortical atrophy than both PD patients and HC, while no differences were observed between the latter. MSA and PD showed lower volume-corrected perfusion values than HC in several cerebellar areas (Crus I, Crus II, right VIIb, right VIIIa, right VIIIb), right caudate and both thalami. MSA and PD patients displayed similar perfusion values in all aforementioned areas, but the right cerebellar area VIIIb (lower in MSA) and right caudate and both thalami (lower in PD). Similar results were obtained when comparing PD and MSA patients with the parkinsonian variant.
CONCLUSIONS
A perfusion reduction was equally observed in both MSA and PD patients in cerebellar areas that are putatively linked to cognitive (i.e., executive) rather than motor functions. The observed hypo-perfusion could not be explained by atrophy, suggesting the involvement of the cerebellum in the pathophysiology of both MSA and PD.
Identifiants
pubmed: 32109737
pii: S1353-8020(20)30038-9
doi: 10.1016/j.parkreldis.2020.02.009
pii:
doi:
Substances chimiques
Spin Labels
0
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
49-55Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.