Subcortical atrophy and perfusion patterns in Parkinson disease and multiple system atrophy |
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| Affiliation: | 1. Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, 2-1-1 Nishitokuta, Yahaba, Iwate, Japan;2. Department of Neurology and Gerontology, Iwate Medical University, Morioka, Iwate, Japan;3. Department of Radiology, Iwate Medical University, Morioka, Iwate, Japan;4. Research & Development Group, Kokubunji, Tokyo, Japan;1. Department of Radiology, Stanford University, Palo Alto, CA, United States;2. Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, United States;3. Neurosciences Program, University of Southern California, Los Angeles, CA, United States;4. Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands |
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| Abstract: | BackgroundThe clinical differentiation between Parkinson disease (PD) and multiple system atrophy (MSA) is difficult.ObjectivesArterial spin labeling (ASL) is an advanced MRI technique that obviates the use of an exogenous contrast agent for the estimation of cerebral perfusion. We explored the value of ASL in combination with structural MRI for the differentiation between PD and MSA.MethodsNinety-four subjects (30 PD, 30 MSA and 34 healthy controls) performed a morphometric and ASL-MRI to measure volume and perfusion values within basal ganglia and cerebellum. A region-of-interest analysis was performed to test for structural atrophy and regional blood flow differences between groups.ResultsMSA patients showed higher subcortical atrophy than both PD patients and HC, while no differences were observed between the latter. MSA and PD showed lower volume-corrected perfusion values than HC in several cerebellar areas (Crus I, Crus II, right VIIb, right VIIIa, right VIIIb), right caudate and both thalami. MSA and PD patients displayed similar perfusion values in all aforementioned areas, but the right cerebellar area VIIIb (lower in MSA) and right caudate and both thalami (lower in PD). Similar results were obtained when comparing PD and MSA patients with the parkinsonian variant.ConclusionsA perfusion reduction was equally observed in both MSA and PD patients in cerebellar areas that are putatively linked to cognitive (i.e., executive) rather than motor functions. The observed hypo-perfusion could not be explained by atrophy, suggesting the involvement of the cerebellum in the pathophysiology of both MSA and PD. |
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| Keywords: | Multiple system atrophy Arterial spin labeling Cerebellum Magnetic resonance imaging Parkinson disease |
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