Dorsolateral nigral hyperintensity on 3.0T susceptibility-weighted imaging in neurodegenerative Parkinsonism.

Abstract

BACKGROUND:

Absence of a hyperintense, ovoid area within the dorsolateral border of the otherwise hypointense pars compacta of the substantia nigra (referred to as dorsolateral nigral hyperintensity) on iron-sensitive high-field magnetic resonance imaging sequences seems to be a typical finding for patients with Parkinson's disease (PD).

OBJECTIVE:

This study was undertaken to evaluate the diagnostic value of the dorsolateral nigral hyperintensity in a cohort of patients with neurodegenerative parkinsonism including PD, multiple system atrophy (MSA), and progressive supranuclear palsy (PSP) as well as healthy controls using high-field susceptibility-weighted imaging (SWI) at 3.0 Tesla (T).

METHODS:

Absence of dorsolateral nigral hyperintensity was assessed on visual inspection of anonymized 3.0T SWI scans in a case-control study including 148 patients with neurodegenerative parkinsonism (PD: n = 104; MSA: n = 22; PSP: n = 22) and 42 healthy controls.

RESULTS:

Dorsolateral nigral hyperintensity was absent unilaterally in all patients with MSA or PSP, in 83 of 90 patients with PD, but only in one of the healthy controls resulting in an overall correct classification of 95.2% in discriminating neurodegenerative parkinsonism from controls in the per-protocol analysis. Overall correct classification was 93.2% in the intent-to-diagnose analysis, including also SWI scans with poor quality (12.1% of all scans) for nigral evaluation.

CONCLUSION:

Visual assessment of dorsolateral nigral hyperintensity on high-field SWI scans may serve as a new simple diagnostic imaging marker for neurodegenerative parkinsonian disorders.

• Authors: Eva Reiter, Christoph Mueller, Bernadette Pinter, Florian Krismer, Christoph Scherfler, Regina Esterhammer, Christian Kremser, Michael Schocke, Gregor K Wenning, Werner Poewe, Klaus Seppi
• Journal: Movement disorders : official journal of the Movement Disorder Society (Mov Disord) Vol. 30 Issue 8 Pg. 1068-76 (Jul 2015) ISSN: 1531-8257 [Electronic] United States
• PMID: 25773707 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2015 International Parkinson and Movement Disorder Society.

Chemical References

• Biomarkers

Topics

• Aged
• Biomarkers
• Case-Control Studies
• Cohort Studies
• Female
• Humans
• Magnetic Resonance Imaging (methods)
• Male
• Middle Aged
• Multiple System Atrophy (pathology)
• Parkinson Disease (pathology)
• Sensitivity and Specificity
• Substantia Nigra (pathology)
• Supranuclear Palsy, Progressive (pathology)