Cerebellar Microstructural Abnormalities in Parkinson’s Disease: a Systematic Review of Diffusion Tensor Imaging Studies

Maryam Haghshomar, Parnian Shobeiri, Seyed Arsalan Seyedi, Fatemeh Abbasi-Feijani, Amirhossein Poopak, Houman Sotoudeh, Arash Kamali, Mohammad Hadi Aarabi
The Cerebellum. 2022-01-10; 21(4): 545-571
DOI: 10.1007/s12311-021-01355-3

1. Cerebellum. 2022 Aug;21(4):545-571. doi: 10.1007/s12311-021-01355-3. Epub 2022
Jan 10.

Cerebellar Microstructural Abnormalities in Parkinson’s Disease: a Systematic
Review of Diffusion Tensor Imaging Studies.

Haghshomar M(#)(1)(2), Shobeiri P(#)(3)(4)(5), Seyedi SA(6), Abbasi-Feijani
F(7), Poopak A(1), Sotoudeh H(8), Kamali A(9), Aarabi MH(10).

Author information:
(1)Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
(2)NeuroImaging Network (NIN), Universal Scientific Education and Research
Network (USERN), Tehran, Iran.
(3)Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
.
(4)NeuroImaging Network (NIN), Universal Scientific Education and Research
Network (USERN), Tehran, Iran. .
(5)Non-Communicable Diseases Research Center, Endocrinology and Metabolism
Population Sciences Institute, Tehran University of Medical Sciences, No. 10,
Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713137, Iran.
.
(6)Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.
(7)Faculty of Medicine, Arak University of Medical Sciences, Tehran, Iran.
(8)Department of Radiology and Neurology, University of Alabama at Birmingham
(UAB), Birmingham, AL, USA.
(9)Department of Diagnostic and Interventional Radiology, University of Texas
McGovern Medical School, Houston, TX, USA.
(10)Department of Neuroscience (DNS), Padova Neuroscience Center-PNC, University
of Padova, Padua, Italy.
(#)Contributed equally

Erratum in
Cerebellum. 2022 Aug;21(4):572. doi: 10.1007/s12311-022-01402-7.

Diffusion tensor imaging (DTI) is now having a strong momentum in research to
evaluate the neural fibers of the CNS. This technique can study white matter
(WM) microstructure in neurodegenerative disorders, including Parkinson’s
disease (PD). Previous neuroimaging studies have suggested cerebellar
involvement in the pathogenesis of PD, and these cerebellum alterations can
correlate with PD symptoms and stages. Using the PRISMA 2020 framework, PubMed
and EMBASE were searched to retrieve relevant articles. Our search revealed 472
articles. After screening titles and abstracts, and full-text review, and
implementing the inclusion criteria, 68 papers were selected for synthesis.
Reviewing the selected studies revealed that the patterns of reduction in
cerebellum WM integrity, assessed by fractional anisotropy, mean diffusivity,
radial diffusivity, and axial diffusivity measures can differ symptoms and
stages of PD. Cerebellar diffusion tensor imaging (DTI) changes in PD patients
with « postural instability and gait difficulty » are significantly different from
« tremor dominant » PD patients. Freezing of the gate is strongly related to
cerebellar involvement depicted by DTI. The « reduced cognition, » « visual
disturbances, » « sleep disorders, » « depression, » and « olfactory dysfunction » are
not related to cerebellum microstructural changes on DTI, while
« impulsive-compulsive behavior » can be linked to cerebellar WM alteration.
Finally, higher PD stages and longer disease duration are associated with
cerebellum white matter alteration depicted by DTI. Depiction of cerebellar
white matter involvement in PD is feasible by DTI. There is an association with
disease duration and severity and several clinical presentations with DTI
findings. This clinical-imaging association may eventually improve disease
management.