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MRI volumetric morphometry in vascular parkinsonism

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Abstract

Vascular parkinsonism is a difficult clinical differential diagnosis in elderly subjects. We aimed at identifying morphometric markers in the brain of elderly patients with vascular parkinsonism (VP) compared with age-matched patients with Parkinson’s disease (PD) and healthy controls. In this multicenter prospective study, 46 patients (80 ± 5 years old; male 32) with parkinsonism (32 PD and 14 VP) and 29 controls (mean age 78 ± 3 years; male 21) underwent brain MRI on a 3-T scanner including T1 MPRAGE and FLAIR sequences. Volumetric morphometry was obtained using Morphobox software and compared between patients and controls. Receiver operating characteristics curve analysis with computation of area under the curve (AUC) was used to compare diagnostic values. Caudate nucleus and white matter hyperintense lesions (WMHL) volumes appeared significantly higher in patients with VP. Normalized caudate volume of at least 0.67% and normalized WMHL of at least 1.11% identified patients with VP from patients with PD and controls with similar performances (p > 0.25). Caudate nucleus and WMHL volumes were positively correlated (ρ = 0.74, p < 0.0001), suggesting vascular disease related remodelling in elderly subjects. Caudate nucleus and WMHL MRI volumes might be used as additional markers to help identify patients with VP in the initial workup of elderly subjects with parkinsonian symptoms.

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Acknowledgements

The authors would like to thank all subjects who participated to this study as well as Benedicte Marechal for her advices and technical assistance in using Morphobox software. This work was supported by grants from the CHRU of Montpellier, which was not involved in any step of the study.

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Authors and Affiliations

  1. Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier, France

    Vincent Dunet, Jeremy Deverdun, Celine Charroud, Emmanuelle Le Bars, Frederic Pinna, Alain Bonafe & Nicolas Menjot de Champfleur

  2. I2FH, Institut d’Imagerie Fonctionnelle Humaine, Hôpital Gui de Chauliac, CHRU de Montpellier, Montpellier, France

    Vincent Dunet, Jeremy Deverdun, Celine Charroud, Emmanuelle Le Bars, Frederic Pinna, Alain Bonafe & Nicolas Menjot de Champfleur

  3. Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Rue du Bugnon 46, 1011, Lausanne, Switzerland

    Vincent Dunet

  4. Laboratoire Charles Coulomb, CNRS, UMR 5221, Montpellier University, Montpellier, France

    Jeremy Deverdun & Francois Molino

  5. Intrasense, Montpellier, France

    Jeremy Deverdun

  6. Neuropsychiatry: Epidemiological and Clinical Research, INSERM U1061-Montpellier University, La Colombiere Hospital, Montpellier, France

    Celine Charroud

  7. INSERM U1198-Montpellier University, Montpellier, France

    Celine Charroud

  8. Institut de Genomique Fonctionnelle, UMNR 5203-INSERM U661-Montpellier University, Montpellier, France

    Francois Molino

  9. Clinique du Parc, Service d’imagerie, Castenau-le-Lez, France

    Sophie Menjot de Champfleur & Christian Geny

  10. Department of Neurology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier, France

    Florence Maury, Mahmoud Charif, Xavier Ayrignac, Pierre Labauge & Frederic Pinna

  11. Department of Neurology, Caremeau University Hospital Center, Nimes, France

    Giovanni Castelnovo

  12. Team “Plasticity of Central Nervous System, Stem Cells and Glial Tumors”, U1051, Institut of Neurosciences of Montpellier, Saint Eloi Hospital, Montpellier, France

    Alain Bonafe & Nicolas Menjot de Champfleur

  13. EuroMov, 700 Avenue du Pic Saint Loup, 34090, Montpellier, France

    Christian Geny

  14. Movement to Health (M2H), Montpellier University, Montpellier, France

    Christian Geny

  15. Department of Medical Imaging, Caremeau University Hospital Center, Nimes, France

    Nicolas Menjot de Champfleur

Authors
  1. Vincent Dunet
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  2. Jeremy Deverdun
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  3. Celine Charroud
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  4. Emmanuelle Le Bars
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  5. Francois Molino
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  6. Sophie Menjot de Champfleur
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  7. Florence Maury
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  8. Mahmoud Charif
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  9. Xavier Ayrignac
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  10. Pierre Labauge
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  11. Giovanni Castelnovo
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  12. Frederic Pinna
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  13. Alain Bonafe
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  14. Christian Geny
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  15. Nicolas Menjot de Champfleur
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Corresponding author

Correspondence to Vincent Dunet.

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Conflicts of interest

The authors declare they have no conflict of interest regarding this study.

Ethical standard

This study was approved by the Institution Ethics Committee and has, therefore, been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

All participants gave their informed consent prior to their inclusion in the study. There are no details in this manuscript that might disclose the identity of the participants.

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Dunet, V., Deverdun, J., Charroud, C. et al. MRI volumetric morphometry in vascular parkinsonism. J Neurol 264, 1511–1519 (2017). https://doi.org/10.1007/s00415-017-8561-5

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  • DOI: https://doi.org/10.1007/s00415-017-8561-5

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