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Cerebellar Microstructural Abnormalities in Parkinson’s Disease: a Systematic Review of Diffusion Tensor Imaging Studies

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A Correction to this article was published on 07 April 2022

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Abstract

Diffusion tensor imaging (DTI) is now having a strong momentum in research to evaluate the neural fibers of the CNS. This technique can study white matter (WM) microstructure in neurodegenerative disorders, including Parkinson’s disease (PD). Previous neuroimaging studies have suggested cerebellar involvement in the pathogenesis of PD, and these cerebellum alterations can correlate with PD symptoms and stages. Using the PRISMA 2020 framework, PubMed and EMBASE were searched to retrieve relevant articles. Our search revealed 472 articles. After screening titles and abstracts, and full-text review, and implementing the inclusion criteria, 68 papers were selected for synthesis. Reviewing the selected studies revealed that the patterns of reduction in cerebellum WM integrity, assessed by fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity measures can differ symptoms and stages of PD. Cerebellar diffusion tensor imaging (DTI) changes in PD patients with “postural instability and gait difficulty” are significantly different from “tremor dominant” PD patients. Freezing of the gate is strongly related to cerebellar involvement depicted by DTI. The “reduced cognition,” “visual disturbances,” “sleep disorders,” “depression,” and “olfactory dysfunction” are not related to cerebellum microstructural changes on DTI, while “impulsive-compulsive behavior” can be linked to cerebellar WM alteration. Finally, higher PD stages and longer disease duration are associated with cerebellum white matter alteration depicted by DTI. Depiction of cerebellar white matter involvement in PD is feasible by DTI. There is an association with disease duration and severity and several clinical presentations with DTI findings. This clinical-imaging association may eventually improve disease management.

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Acknowledgements

We sincerely thank the authors of the included articles in this systematic review due to sharing the relevant data.

Author information

Author notes

  1. Maryam Haghshomar and Parnian Shobeiri contributed equally to this work.

Authors and Affiliations

  1. Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Maryam Haghshomar, Parnian Shobeiri & Amirhossein Poopak

  2. NeuroImaging Network (NIN), Universal Scientific Education and Research Network (USERN), Tehran, Iran

    Maryam Haghshomar & Parnian Shobeiri

  3. Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, No. 10, Al-e-Ahmad and Chamran Highway intersection, Tehran, 1411713137, Iran

    Parnian Shobeiri

  4. Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran

    Seyed Arsalan Seyedi

  5. Faculty of Medicine, Arak University of Medical Sciences, Tehran, Iran

    Fatemeh Abbasi-Feijani

  6. Department of Radiology and Neurology, University of Alabama at Birmingham (UAB), Birmingham, AL, USA

    Houman Sotoudeh

  7. Department of Diagnostic and Interventional Radiology, University of Texas McGovern Medical School, Houston, TX, USA

    Arash Kamali

  8. Department of Neuroscience (DNS), Padova Neuroscience Center-PNC, University of Padova, Padua, Italy

    Mohammad Hadi Aarabi

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  1. Maryam Haghshomar
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  7. Arash Kamali
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Contributions

Conceptualization: MH, PS, MHA; Literature search and data extraction: FA, AP; Formal analysis and investigation: MH, PS, HS; Writing - original draft preparation: MH; Writing - review and editing: PS, HS, AK; All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Parnian Shobeiri.

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Haghshomar, M., Shobeiri, P., Seyedi, S.A. et al. Cerebellar Microstructural Abnormalities in Parkinson’s Disease: a Systematic Review of Diffusion Tensor Imaging Studies. Cerebellum 21, 545–571 (2022). https://doi.org/10.1007/s12311-021-01355-3

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