Multimodal MRI assessment of nigro-striatal pathway in multiple system atrophy and Parkinson disease

Gaetano Barbagallo, Maria Sierra-Peña, Federico Nemmi, Anne Pavy-Le Traon, Wassilios G. Meissner, Olivier Rascol, Patrice Péran
Mov Disord.. 2015-12-17; 31(3): 325-334
DOI: 10.1002/mds.26471

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1. Mov Disord. 2016 Mar;31(3):325-34. doi: 10.1002/mds.26471. Epub 2015 Dec 17.

Multimodal MRI assessment of nigro-striatal pathway in multiple system atrophy
and Parkinson disease.

Barbagallo G(1)(2)(3), Sierra-Peña M(4), Nemmi F(5), Traon AP(6), Meissner
WG(7)(8)(9)(10), Rascol O(1)(2)(6)(11), Péran P(1)(2).

Author information:
(1)INSERM, Imagerie Cérébrale et Handicaps Neurologiques, UMR 825, 31059,
Toulouse, France.
(2)Université de Toulouse (UPS), Imagerie Cérébrale et Handicaps Neurologiques,
Toulouse, France.
(3)Institute of Neurology, University Magna Graecia, Catanzaro, Italy.
(4)Service of Neurology, University Hospital “Marqués de Valdecilla (IFIMAV),”
University of Cantabria and “Centro de Investigación Biomédica en Red de
Enfermedades Neurodegenerativas (CIBERNED),”, Santander, Spain.
(5)Neuroscience Department, Retzius vag 8, Karolinska Institutet, Stockholm,
Sweden.
(6)Centre de Référence Atrophie Multisystématisée, Centre Hospitalier
Universitaire de Toulouse, Toulouse, France.
(7)Centre de Référence Atrophie Multisystématisée, Centre Hospitalier
Universitaire de Bordeaux, Pessac, France.
(8)Service de Neurologie, Centre Hospitalier Universitaire de Bordeaux, Pessac,
France.
(9)Université de Bordeaux, Institut des Maladies Neurodégénératives, Bordeaux,
France.
(10)CNRS, Institut des Maladies Neurodégénératives, Bordeaux, France.
(11)Département de Pharmacologie Clinique, INSERM CIC1436, Centre Hospitalier
Universitaire de Toulouse, Toulouse, France.

BACKGROUND: Parkinson’s disease (PD) and multiple system atrophy (MSA) are two
neurodegenerative alpha-synucleinopathies characterized by severe impairment of
the nigro-striatal pathway. Based on T1-, T2*-, and diffusion-weighted magnetic
resonance imaging (MRI), macro-structural and micro-structural abnormalities in
these diseases can be detected.
OBJECTIVE: This study was undertaken to compare the nigro-striatal changes that
occur in patients with PD with those in patients with both variants of MSA (the
parkinsonian variant, MSA-P, and the cerebellar variant, MSA-C), and to explore
correlations between different MRI parameters and clinical data.
METHODS: We simultaneously measured volume, T2* relaxation rates, and mean
diffusivity in nigro-striatal structures (substantia nigra, caudate nucleus, and
putamen) of 26 patients with PD and 29 patients with MSA (16 with MSA-P and 13
with MSA-C).
RESULTS: Significant changes in the putamina in patients with MSA were observed
compared with patients with PD. Patients with MSA-P had higher mean diffusivity
values in their putamina than did patients with PD or MSA-C. The putamina of both
subgroups of MSA had higher T2* relaxation rates values than PD. Remarkably,
discriminant analysis showed that using two measurements of microstructural
damage (T2* relaxation rates and mean diffusivity in the putamen) allowed 96%
accuracy to distinguish patients with PD from those with MSA-P. Correlation
analyses between MRI findings and clinical variables revealed that patients with
PD showed significant correlations only at the nigra. In patients with MSA,
clinical variables correlated with MRI findings in both the nigra and striatum.
CONCLUSIONS: Multimodal MRI reveals different pattern of nigro-striatal
involvement in patients with PD and patients with MSA.

© 2015 International Parkinson and Movement Disorder Society.

DOI: 10.1002/mds.26471
PMID: 26676922 [Indexed for MEDLINE]

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