Longitudinal quantitative MRI in multiple system atrophy and progressive supranuclear palsy

William Reginold; Anthony E Lang; Connie Marras; Chris Heyn; Mohammed Alharbi; David J Mikulis

doi:10.1016/j.parkreldis.2013.10.002

Longitudinal quantitative MRI in multiple system atrophy and progressive supranuclear palsy

Parkinsonism Relat Disord. 2014 Feb;20(2):222-5. doi: 10.1016/j.parkreldis.2013.10.002. Epub 2013 Oct 12.

Authors

William Reginold¹, Anthony E Lang², Connie Marras³, Chris Heyn⁴, Mohammed Alharbi⁵, David J Mikulis⁶

Affiliations

¹ Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, Canada; Department of Medical Imaging, Toronto Western Hospital, the Joint Department of Medical Imaging, and The University of Toronto, Canada. Electronic address: [email protected].
² Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, Canada; Department of Medicine (Neurology), University of Toronto, Canada. Electronic address: [email protected].
³ Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, Canada; Department of Medicine (Neurology), University of Toronto, Canada. Electronic address: [email protected].
⁴ Department of Medical Imaging, Toronto Western Hospital, the Joint Department of Medical Imaging, and The University of Toronto, Canada. Electronic address: [email protected].
⁵ Department of Medical Imaging, Toronto Western Hospital, the Joint Department of Medical Imaging, and The University of Toronto, Canada. Electronic address: [email protected].
⁶ Department of Medical Imaging, Toronto Western Hospital, the Joint Department of Medical Imaging, and The University of Toronto, Canada. Electronic address: [email protected].

PMID: 24239142
DOI: 10.1016/j.parkreldis.2013.10.002

Abstract

Objective: MRI has been used in parkinsonism to assess atrophy, tissue water diffusivity, and mineral deposition but usually at a single time-point. However, multiple system atrophy (MSA) and progressive supranuclear palsy (PSP) are progressive diseases. This study assessed the value of longitudinal MRI in characterizing the time course of the degenerative process.

Methods: Two serial MRIs (mean 23 months apart) were retrospectively analyzed in 12 MSA, 6 PSP, and 18 age and sex matched controls. Assessment included selected cross-sectional areas, regional apparent diffusion coefficient (ADC) and gradient echo (GRE) intensity ratios of the lateral ventricles, caudate, putamen, middle cerebellar peduncle, pons and midbrain.

Results: On follow-up imaging, there was a larger ADC increase in the putamen in PSP over time compared to controls (p = 0.02). In MSA there was greater volume loss in the pons over time compared to controls (p = 0.002). In MSA the changes in middle cerebellar peduncle ADC were correlated with motor symptom severity according to the Unified Parkinson's Disease Rating Scale Part III (p = 0.005).

Conclusions: Evidence of progressive neurodegeneration can be observed on MRI in MSA and PSP within two years consisting of increasing putaminal ADC in PSP and pontine atrophy in MSA.

Keywords: Diffusion imaging; Gradient echo; Multiple system atrophy; Progressive supranuclear palsy; Volumetric MRI.

MeSH terms

Aged
Brain / pathology*
Disease Progression
Female
Humans
Image Interpretation, Computer-Assisted
Longitudinal Studies
Magnetic Resonance Imaging
Male
Middle Aged
Multiple System Atrophy / pathology*
Supranuclear Palsy, Progressive / pathology*