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Use of diffusion tensor imaging to identify similarities and differences between cerebellar and Parkinsonism forms of multiple system atrophy

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Abstract

Introduction

We performed diffusion tensor imaging to determine if multiple system atrophy (MSA)-cerebellar (C) and MSA-Parkinsonism (P) show similar changes, as shown in pathological studies.

Methods

Nineteen patients with MSA-C, 12 patients with MSA-P, 20 patients with Parkinson disease, and 20 healthy controls were evaluated with the use of voxel-based morphometry analysis of diffusion tensor imaging.

Results

There was an increase in apparent diffusion coefficient values in the middle cerebellar peduncles and cerebellum and a decrease in fractional anisotropy in the pyramidal tract, middle cerebellar peduncles, and white matter of the cerebellum in patients with MSA-C and MSA-P compared to the controls (P < 0.001). In addition, isotropic diffusion-weighted image values were reduced in the cerebellar cortex and deep cerebellar nuclei in patients with MSA-C and increased in the basal ganglia in patients with MSA-P.

Conclusion

These results indicate that despite their disparate clinical manifestations, patients with MSA-C and MSA-P share similar diffusion tensor imaging features in the infratentorial region. Further, the combination of FA, ADC and iDWI images can be used to distinguish between MSA (either form) and Parkinson disease, which has potential therapeutic implications.

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Acknowledgements

This work was supported by grants from the National Science Council, Taipei, Taiwan, ROC (NSC98-214-B-010-036-MY3 and NSC99-2314-B-010-013-MY3), Taipei Veterans General Hospital, Taiwan, ROC (V99-C1-052) and Yen-Tjing-Ling Medical Foundation (CI-98-3).

Conflict of interest statement

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Neurology, School of Medicine, National Yang-Ming University, #155, Sec.2, Linung St., Peitou District, 112, Taipei, Taiwan

    Po-Shan Wang, Hsiu-Mei Wu & Bing-Wen Soong

  2. The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan

    Po-Shan Wang & Bing-Wen Soong

  3. The Neurological Institute, Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan

    Po-Shan Wang

  4. Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan, Republic of China

    Po-Shan Wang & Ching-Po Lin

  5. Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan

    Hsiu-Mei Wu

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  1. Po-Shan Wang
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  2. Hsiu-Mei Wu
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Correspondence to Bing-Wen Soong.

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Wang, PS., Wu, HM., Lin, CP. et al. Use of diffusion tensor imaging to identify similarities and differences between cerebellar and Parkinsonism forms of multiple system atrophy. Neuroradiology 53, 471–481 (2011). https://doi.org/10.1007/s00234-010-0757-7

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  • DOI: https://doi.org/10.1007/s00234-010-0757-7

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