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Imaging nigral pathology and clinical progression in Parkinson's disease§

Authors

  • Guangwei Du MD, PhD,

    1. Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
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  • Mechelle M. Lewis PhD,

    1. Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
    2. Departments of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
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  • Suman Sen MD,

    1. Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
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  • Jianli Wang MD, PhD,

    1. Departments of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
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  • Michele L. Shaffer PhD,

    1. Departments of Public Health Sciences, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
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  • Martin Styner PhD,

    1. Departments of Computer Science, University of North Carolina, Chapel Hill, North Carolina, USA
    2. Departments of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA
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  • Qing X. Yang PhD,

    1. Departments of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
    2. Departments of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
    3. Departments of Bioengineering, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
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  • Xuemei Huang MD, PhD

    Corresponding author
    1. Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
    2. Departments of Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
    3. Departments of Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
    4. Departments of Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
    5. Departments of Kinesiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
    6. Departments of Bioengineering, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
    7. Departments of Neurology, University of North Carolina, Chapel Hill, North Carolina, USA
    • Department of Neurology, Penn State Hershey Medical Center, 500 University Drive, H-037, Hershey, PA 17033-0850, USA
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  • Funding agencies: This work was supported by NS060722 (to X.H.), the HMC GCRC (NIH M01RR10732) and GCRC Construction Grant (C06RR016499), and the National Alliance for Medical Image Computing (NIH U54 EB005149; to M.S.).

  • Relevant conflicts of interest/financial disclosures: Nothing to report.

  • §

    Full financial disclosure and author roles may be found in the online version of this article.

Abstract

The pattern of dopamine cell loss in Parkinson's disease (PD) is known to be prominent in the ventrolateral and caudal substantia nigra (SN), but less severe in the dorsal and rostral region. Both diffusion tensor imaging (DTI) and R2* relaxometry of the SN have been reported as potential markers for PD, but their relative ability to mark disease progression and differences in pathophysiological bases remains unclear. High-resolution T2-weighted, R2*, and DTI were obtained from 28 controls and 40 PD subjects [15 early stage [disease duration ≤1 year], 14 mid stage [duration 2–5 years], and 11 late stage [duration >5 years]). Fractional anisotropy and R2* values in both rostral and caudal SN were obtained for all subjects, and clinical measures (e.g., disease duration, levodopa-equivalent daily dosage, and “off”-drug UPDRS motor score) were obtained for Parkinson's subjects. There was no correlation between fractional anisotropy and clinical measures, whereas R2* was strongly associated with disease progression. Compared to controls, fractional anisotropy in caudal SN was significantly decreased in PD patients of all stages, whereas in rostral SN, it was decreased significantly only in the late-stage group. R2* in both SN regions was significantly increased in the mid- and late-stage, but not early-stage, of PD subjects. These findings suggest that fractional anisotropy changes may mark early pathological changes in caudal SN, whereas the changes in R2* may more closely track PD's clinical progression after symptom onset. © 2012 Movement Disorder Society

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