Comparison of mean diffusivity, R2* relaxation rate and morphometric biomarkers for the clinical differentiation of parkinsonism - Sorbonne Université Access content directly
Journal Articles Parkinsonism & Related Disorders Year : 2023

Comparison of mean diffusivity, R2* relaxation rate and morphometric biomarkers for the clinical differentiation of parkinsonism

François-Xavier Lejeune
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Johann Faouzi
Benjamin Morino
  • Function : Author
Alice Faucher
Nadine Hoyek
David Grabli
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Florence Cormier
  • Function : Author
Marie Vidailhet
Jean-Christophe Corvol
  • Function : Author
Bertrand Degos
  • Function : Author
Olivier Colliot
Stéphane Lehéricy

Abstract

Introduction: Quantitative biomarkers for clinical differentiation of parkinsonian syndromes are still lacking. Our aim was to evaluate the value of combining clinically feasible manual measurements of R2* relaxation rates and mean diffusivity (MD) in subcortical regions and brainstem morphometric measurements to improve the discrimination of parkinsonian syndromes. Methods: Twenty-two healthy controls (HC), 25 patients with Parkinson's disease (PD), 19 with progressive supranuclear palsy (PSP) and 27 with multiple system atrophy (MSA, 21 with the parkinsonian variant -MSAp, 6 with the cerebellar variant -MSAc) were recruited. R2*, MD measurements and morphometric biomarkers including the midbrain to pons area ratio and the Magnetic Resonance Parkinsonism Index (MRPI) were compared between groups and their diagnostic performances were assessed. Results: Morphometric biomarkers discriminated better patients with PSP (ratio: AUC 0.89, MRPI: AUC 0.89) and MSAc (ratio: AUC 0.82, MRPI: AUC 0.75) from other groups. R2* and MD measurements in the posterior putamen performed better in separating patients with MSAp from PD (R2*: AUC 0.89; MD: AUC 0.89). For the three-class classification "MSA vs PD vs PSP", the combination of MD and R2* measurements in the posterior putamen with morphometric biomarkers (AUC: 0.841) outperformed each marker separately. At the individual-level, there were seven discordances between imaging-based prediction and clinical diagnosis involving MSA. Using the new Movement Disorder Society criteria for the diagnosis of MSA, three of these seven patients were clinically reclassified as predicted by quantitative imaging. Conclusion: Combining R2* and MD measurements in the posterior putamen with morphometric biomarkers improves the discrimination of parkinsonism.
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Dates and versions

hal-04041736 , version 1 (22-03-2023)
hal-04041736 , version 2 (04-06-2023)

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Lydia Chougar, François-Xavier Lejeune, Johann Faouzi, Benjamin Morino, Alice Faucher, et al.. Comparison of mean diffusivity, R2* relaxation rate and morphometric biomarkers for the clinical differentiation of parkinsonism. Parkinsonism & Related Disorders, 2023, 108, pp.105287. ⟨10.1016/j.parkreldis.2023.105287⟩. ⟨hal-04041736v2⟩
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