Brain Microstructure Interrogation by Diffusion Tensor and Kurtosis Imaging in Progressive Supranuclear Palsy Subtypes

IF 2.3 4区 医学 Q3 CLINICAL NEUROLOGY
Rodolfo G. Gatto, Hossam Youssef, Nha Trang Thu Pham, Farwa Ali, Heather M. Clark, Julie Stierwalt, Yehkyoung Stephens, Mary M. Machulda, Keith A. Josephs, Jennifer L. Whitwell
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Abstract

Background and Purpose

Diffusion tensor imaging (DTI) is commonly used to assess the integrity of gray and white matter (WM) structures in progressive supranuclear palsy (PSP). Beyond DTI, nontraditional diffusion techniques such as diffusion kurtosis imaging (DKI) have been shown to characterize brain tissue further. In this work, we aim to determine the utility of DKI in the differential diagnosis of PSP—Richardson syndrome (PSP-RS) and PSP with predominant parkinsonism (PSP-P) from Parkinson's disease (PD) and controls.

Methods

A multishell diffusion-weighted sequence was acquired at 3 Tesla on a Siemens system in 22 patients with PSP-RS, 23 with PSP-P, 19 with PD, and 19 controls. Fractional anisotropy, mean diffusivity, kurtosis fractional anisotropy (KFA), and mean kurtosis (Kmean) were calculated for nine deep gray matter regions and six different WM tracts.

Results

DKI identified differences (not found by DTI) between control and PSP groups in the globus pallidum externus, subthalamic region, and putamen, with Kmean in the putamen able to differentiate PSP-RS and PD. DKI WM measurements in the body of the corpus callosum and dentatorubrothalamic tract differentiated PSP-RS from PD, and the corticostriatal tract differentiated PSP-P from PD. KFA in the body of the corpus callosum identified worse microstructural anomalies in PSP-RS compared to PSP-P. DKI metrics correlated with the severity of ocular motor impairment and parkinsonism scores.

Conclusions

DKI measurements could differentiate PSP-RS, PSP-P, and PD and, hence, may be a promising imaging tool for studying structural neuropathological changes in PSP.

扩散张量和峰度成像对进行性核上性麻痹亚型脑微观结构的研究
背景与目的弥散张量成像(DTI)通常用于评估进行性核上性麻痹(PSP)的灰质和白质(WM)结构的完整性。除了DTI,非传统的弥散技术,如弥散峰度成像(DKI)已被证明可以进一步表征脑组织。在这项工作中,我们的目的是确定DKI在帕金森病(PD)和对照的PSP- richardson综合征(PSP- rs)和PSP伴显性帕金森病(PSP- p)的鉴别诊断中的应用。方法对22例PSP-RS患者、23例PSP-P患者、19例PD患者和19例对照患者在Siemens系统上进行3特斯拉时的多壳弥散加权序列测定。计算了9个深灰质区域和6个不同WM束的分数各向异性、平均扩散率、峰度分数各向异性(KFA)和平均峰度(Kmean)。结果DKI识别出对照组和PSP组在外白球、丘底区和壳核的差异(DTI未发现),而壳核中的Kmean能够区分PSP- rs和PD。胼胝体和齿状丘脑束的DKI WM测量将PSP-RS与PD区分开来,皮质纹状体束将PSP-P与PD区分开来。胼胝体体的KFA鉴定PSP-RS的显微结构异常比PSP-P更严重。DKI指标与眼运动障碍的严重程度和帕金森评分相关。结论DKI测量可以区分PSP- rs、PSP- p和PD,因此可能是研究PSP结构神经病理改变的一种有前景的成像工具。
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来源期刊
Journal of Neuroimaging
Journal of Neuroimaging 医学-核医学
CiteScore
4.70
自引率
0.00%
发文量
117
审稿时长
6-12 weeks
期刊介绍: Start reading the Journal of Neuroimaging to learn the latest neurological imaging techniques. The peer-reviewed research is written in a practical clinical context, giving you the information you need on: MRI CT Carotid Ultrasound and TCD SPECT PET Endovascular Surgical Neuroradiology Functional MRI Xenon CT and other new and upcoming neuroscientific modalities.The Journal of Neuroimaging addresses the full spectrum of human nervous system disease, including stroke, neoplasia, degenerating and demyelinating disease, epilepsy, tumors, lesions, infectious disease, cerebral vascular arterial diseases, toxic-metabolic disease, psychoses, dementias, heredo-familial disease, and trauma.Offering original research, review articles, case reports, neuroimaging CPCs, and evaluations of instruments and technology relevant to the nervous system, the Journal of Neuroimaging focuses on useful clinical developments and applications, tested techniques and interpretations, patient care, diagnostics, and therapeutics. Start reading today!
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