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Differentiation of early-stage parkinsonisms using neuromelanin-sensitive magnetic resonance imaging.

AbstractPURPOSE:
The purpose of this study was to investigate whether the signal intensity of the substantia nigra pars compacta (SNc) and locus coeruleus (LC) on neuromelanin-sensitive magnetic resonance imaging (MRI) can discriminate early-stage parkinsonism disorders, for which differential diagnosis is generally difficult.
METHODS:
Neuromelanin-sensitive MRI at 3 T was performed in 53 patients with early parkinsonism and 22 healthy controls. After an observation period of >1.5 year, the patients were clinically diagnosed with Parkinson's disease (PD; n = 30), multiple system atrophy with predominant parkinsonism (MSA-P; n = 10), or progressive supranuclear palsy syndrome (PSPS; n = 13). The signal intensity of the lateral, central, and medial parts of the SNc and the LC were measured and the contrast ratios (CR) against adjacent white-matter structures was calculated.
RESULTS:
The CR of the lateral SNc was lower in the PD and MSA-P groups than in the PSPS and control groups (p = 0.0001-0.05). The CR of the LC was lower in the PD group than in the other groups (p = 0.0001-0.05). Sensitivity and specificity of the CRs for discriminating PD from MSA-P was 60% and 90%, respectively, those for PD/PSPS were 63-88% and 77-92%, respectively, and those for MSA-P/PSPS were 80% and 85%, respectively. These properties were comparable or better to MIBG scintigraphy.
CONCLUSIONS:
Neuromelanin-sensitive MRI can depict differences in signal intensity of the lateral SNc and the LC among the parkinsonism disorders at their early stages.
AuthorsChigumi Ohtsuka, Makoto Sasaki, Kanako Konno, Kanako Kato, Junko Takahashi, Fumio Yamashita, Yasuo Terayama
JournalParkinsonism & related disorders (Parkinsonism Relat Disord) Vol. 20 Issue 7 Pg. 755-60 (Jul 2014) ISSN: 1873-5126 [Electronic] England
PMID24768616 (Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2014 Elsevier Ltd. All rights reserved.
Chemical References
  • Melanins
  • neuromelanin
Topics
  • Aged
  • Aged, 80 and over
  • Diagnosis, Differential
  • Early Diagnosis
  • Female
  • Humans
  • Locus Coeruleus (metabolism, pathology)
  • Magnetic Resonance Imaging (methods)
  • Male
  • Melanins
  • Middle Aged
  • Parkinsonian Disorders (diagnosis, metabolism)
  • Substantia Nigra (metabolism, pathology)

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