Patterns of diffusion kurtosis changes in Parkinson's disease subtypes

Autor: Alzbeta Sejnoha Minsterova, Zoltan Galaz, Lubomira Novakova, Jiri Mekyska, Irena Rektorová, Patricia Klobusiakova, Adrian Pies, Nela Nemcova Elfmarkova
Rok vydání: 2020
Předmět:
0301 basic medicine
Male
diffusion kurtosis imaging
MRI
Diffusion kurtosis imaging
Parkinson's disease
Mild cognitive impairment
Diagnostic marker
medicine.medical_specialty
Hippocampus
Substantia nigra
Audiology
Basal Ganglia
White matter
03 medical and health sciences
mild cognitive impairment
0302 clinical medicine
Atrophy
Thalamus
Basal ganglia
medicine
Humans
Cognitive Dysfunction
Gray Matter
Diffusion Kurtosis Imaging
Aged
Models
Statistical
diagnostic marker
business.industry
Motor Cortex
Brain
Parkinson Disease
Middle Aged
medicine.disease
White Matter
030104 developmental biology
medicine.anatomical_structure
Diffusion Magnetic Resonance Imaging
Diffusion Tensor Imaging
Logistic Models
Neurology
Multivariate Analysis
Kurtosis
Female
Neurology (clinical)
Geriatrics and Gerontology
business
030217 neurology & neurosurgery
Zdroj: Parkinsonism & Related Disorders
PARKINSONISM & RELATED DISORDERS
PARKINSONISM & RELATED DISORDERS. 2020, vol. 81, issue 1, p. 96-102.
ISSN: 1353-8020
DOI: 10.1016/j.parkreldis.2020.10.032
Popis: Background Diffusion kurtosis imaging has been applied to evaluate white matter and basal ganglia microstructure in mixed Parkinson's disease (PD) groups with inconclusive results. Objectives To evaluate specific patterns of kurtosis changes in PD and to assess the utility of diffusion imaging in differentiating between healthy subjects and cognitively normal PD, and between PD with and without mild cognitive impairment. Methods Diffusion scans were obtained in 92 participants using 3T MRI. Differences in white matter were tested by tract-based spatial statistics. Gray matter was evaluated in basal ganglia, thalamus, hippocampus, and motor and premotor cortices. Brain atrophy was also assessed. Multivariate logistic regression was used to identify a combination of diffusion parameters with the highest discrimination power between groups. Results Diffusion kurtosis metrics showed a significant increase in substantia nigra (p = 0.037, Hedges' g = 0.89), premotor (p = 0.009, Hedges' g = 0.85) and motor (p = 0.033, Hedges' g = 0.87) cortices in PD with normal cognition compared to healthy participants. Combined diffusion markers in gray matter reached 81% accuracy in differentiating between both groups. Significant white matter microstructural changes, and kurtosis decreases in the cortex were present in cognitively impaired versus cognitively normal PD. Diffusion parameters from white and gray matter differentiated between both PD phenotypes with 78% accuracy. Conclusions Increased kurtosis in gray matter structures in cognitively normal PD reflects increased hindrance to water diffusion caused probably by alpha-synuclein-related microstructural changes. In cognitively impaired PD, the changes are mostly driven by decreased white matter integrity. Our results support the utility of diffusion kurtosis imaging for PD diagnostics.
Databáze: OpenAIRE
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