In vivo demonstration of microstructural brain pathology in progressive supranuclear palsy: A DTI study using TBSS
Identifieur interne : 001117 ( Istex/Corpus ); précédent : 001116; suivant : 001118In vivo demonstration of microstructural brain pathology in progressive supranuclear palsy: A DTI study using TBSS
Auteurs : Susanne Knake ; Marcus Belke ; Katja Menzler ; Ulrich Pilatus ; Karla M. Eggert ; Wolfgang H. Oertel ; Maria Stamelou ; Günter U. HöglingerSource :
- Movement Disorders [ 0885-3185 ] ; 2010-07-15.
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Abstract
We investigated DTI changes, potentially indicating alterations of microstructure and brain tissue integrity in 13 patients with probable progressive supranuclear palsy (PSP, Richardson syndrome) at stage III or less and 10 age‐matched controls using a whole brain analysis of diffusion tensor imaging (DTI) data. DTI images were analyzed using tract‐based spatial statistics, a hypothesis‐free technique. Fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD) were determined. In patients with PSP, significant increases in FA (P < 0.0001), an unspecific measure of microstructural tissue integrity, were found in the cerebellum and in the superior cerebellar peduncle bilaterally, in the fornix, the body of the corpus callosum and the olfactory region, when compared with age‐matched healthy controls. Further, regional reductions in AD (P < 0.0001), an indicator of altered axonal integrity, were observed in the pons, the right substantia nigra and the cerebellar white matter bilaterally. Significant increases in RD (P < 0.0001), a potential measure of altered myelin integrity, occurred bilaterally in the superior cerebellar peduncle, the cerebellar white matter, the vermis of the cerebellum, the fornix, the body of the corpus callosum, and the olfactory region. RD values in the superior cerebellar peduncle discriminated patients with PSP and controls with high sensitivity (0.92) and specificity (1.0). The findings are supported by neuropathological studies. Our data suggest the usefulness of this clinically available new technique as a possible tool for differential diagnosis. © 2010 Movement Disorder Society
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DOI: 10.1002/mds.23054
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Oertel</name><affiliation><mods:affiliation>Department of Neurology, Philipps University, Marburg, Germany</mods:affiliation></affiliation></author><author><name sortKey="Stamelou, Maria" sort="Stamelou, Maria" uniqKey="Stamelou M" first="Maria" last="Stamelou">Maria Stamelou</name><affiliation><mods:affiliation>Department of Neurology, Philipps University, Marburg, Germany</mods:affiliation></affiliation></author><author><name sortKey="Hoglinger, Gunter U" sort="Hoglinger, Gunter U" uniqKey="Hoglinger G" first="Günter U." last="Höglinger">Günter U. Höglinger</name><affiliation><mods:affiliation>Department of Neurology, Philipps University, Marburg, Germany</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2010-07-15">2010-07-15</date><biblScope unit="vol">25</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" from="1232">1232</biblScope><biblScope unit="page" to="1238">1238</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">4E4DF398AD2DE7009AE2C330480EA754A6753340</idno><idno type="DOI">10.1002/mds.23054</idno><idno type="ArticleID">MDS23054</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>DTI</term><term>MRI</term><term>PSP</term><term>Parkinson's syndrome</term><term>TBSS</term><term>diffusion‐weighted imaging</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">We investigated DTI changes, potentially indicating alterations of microstructure and brain tissue integrity in 13 patients with probable progressive supranuclear palsy (PSP, Richardson syndrome) at stage III or less and 10 age‐matched controls using a whole brain analysis of diffusion tensor imaging (DTI) data. DTI images were analyzed using tract‐based spatial statistics, a hypothesis‐free technique. Fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD) were determined. In patients with PSP, significant increases in FA (P < 0.0001), an unspecific measure of microstructural tissue integrity, were found in the cerebellum and in the superior cerebellar peduncle bilaterally, in the fornix, the body of the corpus callosum and the olfactory region, when compared with age‐matched healthy controls. Further, regional reductions in AD (P < 0.0001), an indicator of altered axonal integrity, were observed in the pons, the right substantia nigra and the cerebellar white matter bilaterally. Significant increases in RD (P < 0.0001), a potential measure of altered myelin integrity, occurred bilaterally in the superior cerebellar peduncle, the cerebellar white matter, the vermis of the cerebellum, the fornix, the body of the corpus callosum, and the olfactory region. RD values in the superior cerebellar peduncle discriminated patients with PSP and controls with high sensitivity (0.92) and specificity (1.0). The findings are supported by neuropathological studies. Our data suggest the usefulness of this clinically available new technique as a possible tool for differential diagnosis. © 2010 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Susanne Knake MD</name><affiliations><json:string>Department of Neurology, Philipps University, Marburg, Germany</json:string></affiliations></json:item><json:item><name>Marcus Belke</name><affiliations><json:string>Department of Neurology, Philipps University, Marburg, Germany</json:string></affiliations></json:item><json:item><name>Katja Menzler MD</name><affiliations><json:string>Department of Neurology, Philipps University, Marburg, Germany</json:string></affiliations></json:item><json:item><name>Ulrich Pilatus MD</name><affiliations><json:string>Brain Imaging Center, J.W. Goethe University, Frankfurt, Germany</json:string></affiliations></json:item><json:item><name>Karla M. Eggert MD</name><affiliations><json:string>Department of Neurology, Philipps University, Marburg, Germany</json:string></affiliations></json:item><json:item><name>Wolfgang H. Oertel MD</name><affiliations><json:string>Department of Neurology, Philipps University, Marburg, Germany</json:string></affiliations></json:item><json:item><name>Maria Stamelou MD</name><affiliations><json:string>Department of Neurology, Philipps University, Marburg, Germany</json:string></affiliations></json:item><json:item><name>Günter U. Höglinger MD</name><affiliations><json:string>Department of Neurology, Philipps University, Marburg, Germany</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>DTI</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>MRI</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>PSP</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>TBSS</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's syndrome</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>diffusion‐weighted imaging</value></json:item></subject><language><json:string>eng</json:string></language><abstract>We investigated DTI changes, potentially indicating alterations of microstructure and brain tissue integrity in 13 patients with probable progressive supranuclear palsy (PSP, Richardson syndrome) at stage III or less and 10 age‐matched controls using a whole brain analysis of diffusion tensor imaging (DTI) data. DTI images were analyzed using tract‐based spatial statistics, a hypothesis‐free technique. Fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD) were determined. In patients with PSP, significant increases in FA (P > 0.0001), an unspecific measure of microstructural tissue integrity, were found in the cerebellum and in the superior cerebellar peduncle bilaterally, in the fornix, the body of the corpus callosum and the olfactory region, when compared with age‐matched healthy controls. Further, regional reductions in AD (P > 0.0001), an indicator of altered axonal integrity, were observed in the pons, the right substantia nigra and the cerebellar white matter bilaterally. Significant increases in RD (P > 0.0001), a potential measure of altered myelin integrity, occurred bilaterally in the superior cerebellar peduncle, the cerebellar white matter, the vermis of the cerebellum, the fornix, the body of the corpus callosum, and the olfactory region. RD values in the superior cerebellar peduncle discriminated patients with PSP and controls with high sensitivity (0.92) and specificity (1.0). The findings are supported by neuropathological studies. Our data suggest the usefulness of this clinically available new technique as a possible tool for differential diagnosis. © 2010 Movement Disorder Society</abstract><qualityIndicators><score>6.596</score><pdfVersion>1.3</pdfVersion><pdfPageSize>612 x 810 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractCharCount>1653</abstractCharCount><pdfWordCount>3752</pdfWordCount><pdfCharCount>25093</pdfCharCount><pdfPageCount>7</pdfPageCount><abstractWordCount>237</abstractWordCount></qualityIndicators><title>In vivo demonstration of microstructural brain pathology in progressive supranuclear palsy: A DTI study using TBSS</title><genre><json:string>Serial article</json:string></genre><host><volume>25</volume><pages><total>7</total><last>1238</last><first>1232</first></pages><issn><json:string>0885-3185</json:string></issn><issue>9</issue><subject><json:item><value>Research Article</value></json:item></subject><genre></genre><language><json:string>unknown</json:string></language><title>Movement Disorders</title><doi><json:string>10.1002/(ISSN)1531-8257</json:string></doi></host><publicationDate>2010</publicationDate><copyrightDate>2010</copyrightDate><doi><json:string>10.1002/mds.23054</json:string></doi><id>4E4DF398AD2DE7009AE2C330480EA754A6753340</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/4E4DF398AD2DE7009AE2C330480EA754A6753340/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/4E4DF398AD2DE7009AE2C330480EA754A6753340/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/4E4DF398AD2DE7009AE2C330480EA754A6753340/fulltext/tei"><teiHeader type="text"><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">In vivo demonstration of microstructural brain pathology in progressive supranuclear palsy: A DTI study using TBSS</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><availability><p>Wiley Subscription Services, Inc., A Wiley Company</p></availability><date>2010</date></publicationStmt><notesStmt><note type="content">*Potential conflict of interest: None reported.</note><note>UKGM Research Grant</note><note>Pitzer Foundation</note><note>Hellenic neurological society (ENEE)</note><note>Deutsche Forschungsgemeinschaft (DFG) - No. HO2402/6‐1;</note><note>Von Behring‐Röntgen‐Stiftung</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">In vivo demonstration of microstructural brain pathology in progressive supranuclear palsy: A DTI study using TBSS</title><author><persName><forename type="first">Susanne</forename><surname>Knake</surname><roleName type="degree">MD</roleName></persName><note type="biography">Susanne Knake and Marcus Belke as well as Maria Stamelou and Günter U. Höglinger contributed equally to this work.</note><affiliation>Susanne Knake and Marcus Belke as well as Maria Stamelou and Günter U. Höglinger contributed equally to this work.</affiliation><note type="correspondence"><p>Correspondence: Department of Neurology, Philipps University, Rudolf‐Bultmann Str. 8, Marburg D‐35033, Germany</p></note><affiliation>Department of Neurology, Philipps University, Marburg, Germany</affiliation></author><author><persName><forename type="first">Marcus</forename><surname>Belke</surname></persName><note type="biography">Susanne Knake and Marcus Belke as well as Maria Stamelou and Günter U. Höglinger contributed equally to this work.</note><affiliation>Susanne Knake and Marcus Belke as well as Maria Stamelou and Günter U. Höglinger contributed equally to this work.</affiliation><affiliation>Department of Neurology, Philipps University, Marburg, Germany</affiliation></author><author><persName><forename type="first">Katja</forename><surname>Menzler</surname><roleName type="degree">MD</roleName></persName><affiliation>Department of Neurology, Philipps University, Marburg, Germany</affiliation></author><author><persName><forename type="first">Ulrich</forename><surname>Pilatus</surname><roleName type="degree">MD</roleName></persName><affiliation>Brain Imaging Center, J.W. Goethe University, Frankfurt, Germany</affiliation></author><author><persName><forename type="first">Karla M.</forename><surname>Eggert</surname><roleName type="degree">MD</roleName></persName><affiliation>Department of Neurology, Philipps University, Marburg, Germany</affiliation></author><author><persName><forename type="first">Wolfgang H.</forename><surname>Oertel</surname><roleName type="degree">MD</roleName></persName><affiliation>Department of Neurology, Philipps University, Marburg, Germany</affiliation></author><author><persName><forename type="first">Maria</forename><surname>Stamelou</surname><roleName type="degree">MD</roleName></persName><note type="biography">Susanne Knake and Marcus Belke as well as Maria Stamelou and Günter U. Höglinger contributed equally to this work.</note><affiliation>Susanne Knake and Marcus Belke as well as Maria Stamelou and Günter U. Höglinger contributed equally to this work.</affiliation><affiliation>Department of Neurology, Philipps University, Marburg, Germany</affiliation></author><author><persName><forename type="first">Günter U.</forename><surname>Höglinger</surname><roleName type="degree">MD</roleName></persName><note type="biography">Susanne Knake and Marcus Belke as well as Maria Stamelou and Günter U. Höglinger contributed equally to this work.</note><affiliation>Susanne Knake and Marcus Belke as well as Maria Stamelou and Günter U. Höglinger contributed equally to this work.</affiliation><affiliation>Department of Neurology, Philipps University, Marburg, Germany</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="pISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><idno type="DOI">10.1002/(ISSN)1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2010-07-15"></date><biblScope unit="vol">25</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" from="1232">1232</biblScope><biblScope unit="page" to="1238">1238</biblScope></imprint></monogr><idno type="istex">4E4DF398AD2DE7009AE2C330480EA754A6753340</idno><idno type="DOI">10.1002/mds.23054</idno><idno type="ArticleID">MDS23054</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2010</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>We investigated DTI changes, potentially indicating alterations of microstructure and brain tissue integrity in 13 patients with probable progressive supranuclear palsy (PSP, Richardson syndrome) at stage III or less and 10 age‐matched controls using a whole brain analysis of diffusion tensor imaging (DTI) data. DTI images were analyzed using tract‐based spatial statistics, a hypothesis‐free technique. Fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD) were determined. In patients with PSP, significant increases in FA (P < 0.0001), an unspecific measure of microstructural tissue integrity, were found in the cerebellum and in the superior cerebellar peduncle bilaterally, in the fornix, the body of the corpus callosum and the olfactory region, when compared with age‐matched healthy controls. Further, regional reductions in AD (P < 0.0001), an indicator of altered axonal integrity, were observed in the pons, the right substantia nigra and the cerebellar white matter bilaterally. Significant increases in RD (P < 0.0001), a potential measure of altered myelin integrity, occurred bilaterally in the superior cerebellar peduncle, the cerebellar white matter, the vermis of the cerebellum, the fornix, the body of the corpus callosum, and the olfactory region. RD values in the superior cerebellar peduncle discriminated patients with PSP and controls with high sensitivity (0.92) and specificity (1.0). The findings are supported by neuropathological studies. Our data suggest the usefulness of this clinically available new technique as a possible tool for differential diagnosis. © 2010 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>DTI</term></item><item><term>MRI</term></item><item><term>PSP</term></item><item><term>TBSS</term></item><item><term>Parkinson's syndrome</term></item><item><term>diffusion‐weighted imaging</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>Article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2009-10-15">Received</change><change when="2010-01-27">Registration</change><change when="2010-07-15">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/4E4DF398AD2DE7009AE2C330480EA754A6753340/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="short">Mov. Disord.</title></titleGroup></publicationMeta><publicationMeta level="part" position="90"><doi origin="wiley" registered="yes">10.1002/mds.v25:9</doi><numberingGroup><numbering type="journalVolume" number="25">25</numbering><numbering type="journalIssue">9</numbering></numberingGroup><coverDate startDate="2010-07-15">15 July 2010</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="180" status="forIssue"><doi origin="wiley" registered="yes">10.1002/mds.23054</doi><idGroup><id type="unit" value="MDS23054"></id></idGroup><countGroup><count type="pageTotal" number="7"></count></countGroup><titleGroup><title type="articleCategory">Research Article</title><title type="tocHeading1">Research Articles</title></titleGroup><copyright ownership="thirdParty">Copyright © 2010 Movement Disorder Society</copyright><eventGroup><event type="manuscriptReceived" date="2009-10-15"></event><event type="manuscriptRevised" date="2009-12-29"></event><event type="manuscriptAccepted" date="2010-01-27"></event><event type="firstOnline" date="2010-03-10"></event><event type="publishedOnlineFinalForm" date="2010-07-19"></event><event type="publishedOnlineAcceptedOrEarlyUnpaginated" date="2010-03-10"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:2.4.8 mode:FullText" date="2011-05-03"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-02"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-31"></event></eventGroup><numberingGroup><numbering type="pageFirst">1232</numbering><numbering type="pageLast">1238</numbering></numberingGroup><correspondenceTo>Department of Neurology, Philipps University, Rudolf‐Bultmann Str. 8, Marburg D‐35033, Germany</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:MDS.MDS23054.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="2"></count><count type="tableTotal" number="2"></count><count type="referenceTotal" number="27"></count><count type="wordTotal" number="4913"></count></countGroup><titleGroup><title type="main" xml:lang="en">In vivo demonstration of microstructural brain pathology in progressive supranuclear palsy: A DTI study using TBSS<link href="#fn1"></link></title><title type="short" xml:lang="en">DTI Microalterations in PSP</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1" corresponding="yes" noteRef="#fn2"><personName><givenNames>Susanne</givenNames><familyName>Knake</familyName><degrees>MD</degrees></personName><contactDetails><email normalForm="knake@staff.uni-marburg.de">knake@staff.uni‐marburg.de</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1" noteRef="#fn2"><personName><givenNames>Marcus</givenNames><familyName>Belke</familyName></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Katja</givenNames><familyName>Menzler</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Ulrich</givenNames><familyName>Pilatus</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Karla M.</givenNames><familyName>Eggert</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Wolfgang H.</givenNames><familyName>Oertel</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af1" noteRef="#fn2"><personName><givenNames>Maria</givenNames><familyName>Stamelou</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af1" noteRef="#fn2"><personName><givenNames>Günter U.</givenNames><familyName>Höglinger</familyName><degrees>MD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="DE" type="organization"><unparsedAffiliation>Department of Neurology, Philipps University, Marburg, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="DE" type="organization"><unparsedAffiliation>Brain Imaging Center, J.W. Goethe University, Frankfurt, Germany</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">DTI</keyword><keyword xml:id="kwd2">MRI</keyword><keyword xml:id="kwd3">PSP</keyword><keyword xml:id="kwd4">TBSS</keyword><keyword xml:id="kwd5">Parkinson's syndrome</keyword><keyword xml:id="kwd6">diffusion‐weighted imaging</keyword></keywordGroup><fundingInfo><fundingAgency>UKGM Research Grant</fundingAgency></fundingInfo><fundingInfo><fundingAgency>Pitzer Foundation</fundingAgency></fundingInfo><fundingInfo><fundingAgency>Hellenic neurological society (ENEE)</fundingAgency></fundingInfo><fundingInfo><fundingAgency>Deutsche Forschungsgemeinschaft (DFG)</fundingAgency><fundingNumber>HO2402/6‐1</fundingNumber></fundingInfo><fundingInfo><fundingAgency>Von Behring‐Röntgen‐Stiftung</fundingAgency></fundingInfo><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>We investigated DTI changes, potentially indicating alterations of microstructure and brain tissue integrity in 13 patients with probable progressive supranuclear palsy (PSP, Richardson syndrome) at stage III or less and 10 age‐matched controls using a whole brain analysis of diffusion tensor imaging (DTI) data. DTI images were analyzed using tract‐based spatial statistics, a hypothesis‐free technique. Fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD) were determined. In patients with PSP, significant increases in FA (<i>P</i> < 0.0001), an unspecific measure of microstructural tissue integrity, were found in the cerebellum and in the superior cerebellar peduncle bilaterally, in the fornix, the body of the corpus callosum and the olfactory region, when compared with age‐matched healthy controls. Further, regional reductions in AD (<i>P</i> < 0.0001), an indicator of altered axonal integrity, were observed in the pons, the right substantia nigra and the cerebellar white matter bilaterally. Significant increases in RD (<i>P</i> < 0.0001), a potential measure of altered myelin integrity, occurred bilaterally in the superior cerebellar peduncle, the cerebellar white matter, the vermis of the cerebellum, the fornix, the body of the corpus callosum, and the olfactory region. RD values in the superior cerebellar peduncle discriminated patients with PSP and controls with high sensitivity (0.92) and specificity (1.0). The findings are supported by neuropathological studies. Our data suggest the usefulness of this clinically available new technique as a possible tool for differential diagnosis. © 2010 Movement Disorder Society</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><p>Potential conflict of interest: None reported.</p></note><note xml:id="fn2"><p>Susanne Knake and Marcus Belke as well as Maria Stamelou and Günter U. Höglinger contributed equally to this work.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><!--Version 0.6 générée le 4-12-2015--><mods version="3.6"><titleInfo lang="en"><title>In vivo demonstration of microstructural brain pathology in progressive supranuclear palsy: A DTI study using TBSS</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>DTI Microalterations in PSP</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>In vivo demonstration of microstructural brain pathology in progressive supranuclear palsy: A DTI study using TBSS</title></titleInfo><name type="personal"><namePart type="given">Susanne</namePart><namePart type="family">Knake</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, Philipps University, Marburg, Germany</affiliation><description>Susanne Knake and Marcus Belke as well as Maria Stamelou and Günter U. Höglinger contributed equally to this work.</description><description>Correspondence: Department of Neurology, Philipps University, Rudolf‐Bultmann Str. 8, Marburg D‐35033, Germany</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Marcus</namePart><namePart type="family">Belke</namePart><affiliation>Department of Neurology, Philipps University, Marburg, Germany</affiliation><description>Susanne Knake and Marcus Belke as well as Maria Stamelou and Günter U. Höglinger contributed equally to this work.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Katja</namePart><namePart type="family">Menzler</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, Philipps University, Marburg, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ulrich</namePart><namePart type="family">Pilatus</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Brain Imaging Center, J.W. Goethe University, Frankfurt, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Karla M.</namePart><namePart type="family">Eggert</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, Philipps University, Marburg, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Wolfgang H.</namePart><namePart type="family">Oertel</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, Philipps University, Marburg, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Maria</namePart><namePart type="family">Stamelou</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, Philipps University, Marburg, Germany</affiliation><description>Susanne Knake and Marcus Belke as well as Maria Stamelou and Günter U. Höglinger contributed equally to this work.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Günter U.</namePart><namePart type="family">Höglinger</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, Philipps University, Marburg, Germany</affiliation><description>Susanne Knake and Marcus Belke as well as Maria Stamelou and Günter U. Höglinger contributed equally to this work.</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre authority="originalCategForm">article</genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2010-07-15</dateIssued><dateCaptured encoding="w3cdtf">2009-10-15</dateCaptured><dateValid encoding="w3cdtf">2010-01-27</dateValid><copyrightDate encoding="w3cdtf">2010</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">2</extent><extent unit="tables">2</extent><extent unit="references">27</extent><extent unit="words">4913</extent></physicalDescription><abstract lang="en">We investigated DTI changes, potentially indicating alterations of microstructure and brain tissue integrity in 13 patients with probable progressive supranuclear palsy (PSP, Richardson syndrome) at stage III or less and 10 age‐matched controls using a whole brain analysis of diffusion tensor imaging (DTI) data. DTI images were analyzed using tract‐based spatial statistics, a hypothesis‐free technique. Fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD) were determined. In patients with PSP, significant increases in FA (P < 0.0001), an unspecific measure of microstructural tissue integrity, were found in the cerebellum and in the superior cerebellar peduncle bilaterally, in the fornix, the body of the corpus callosum and the olfactory region, when compared with age‐matched healthy controls. Further, regional reductions in AD (P < 0.0001), an indicator of altered axonal integrity, were observed in the pons, the right substantia nigra and the cerebellar white matter bilaterally. Significant increases in RD (P < 0.0001), a potential measure of altered myelin integrity, occurred bilaterally in the superior cerebellar peduncle, the cerebellar white matter, the vermis of the cerebellum, the fornix, the body of the corpus callosum, and the olfactory region. RD values in the superior cerebellar peduncle discriminated patients with PSP and controls with high sensitivity (0.92) and specificity (1.0). The findings are supported by neuropathological studies. Our data suggest the usefulness of this clinically available new technique as a possible tool for differential diagnosis. © 2010 Movement Disorder Society</abstract><note type="content">*Potential conflict of interest: None reported.</note><note type="funding">UKGM Research Grant</note><note type="funding">Pitzer Foundation</note><note type="funding">Hellenic neurological society (ENEE)</note><note type="funding">Deutsche Forschungsgemeinschaft (DFG) - No. HO2402/6‐1; </note><note type="funding">Von Behring‐Röntgen‐Stiftung</note><subject lang="en"><genre>Keywords</genre><topic>DTI</topic><topic>MRI</topic><topic>PSP</topic><topic>TBSS</topic><topic>Parkinson's syndrome</topic><topic>diffusion‐weighted imaging</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. 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