Diffusion weighted imaging best discriminates PD from MSA-P : A comparison with tilt table testing and heart MIBG scintigraphy
Identifieur interne : 004301 ( Main/Merge ); précédent : 004300; suivant : 004302Diffusion weighted imaging best discriminates PD from MSA-P : A comparison with tilt table testing and heart MIBG scintigraphy
Auteurs : Martin Köllensperger [Autriche] ; Klaus Seppi [Autriche] ; Claudia Liener [Autriche] ; Sylvia Boesch [Autriche] ; Dirk Heute [Autriche] ; Katherina J. Mair [Autriche] ; Joerg Mueller [Autriche] ; Martin Sawires [Autriche] ; Christoph Scherfler [Autriche] ; Michael F. Schocke [Autriche] ; Eveline Donnemiller [Autriche] ; Irene Virgolini [Autriche] ; Gregor K. Wenning [Autriche] ; Werner Poewe [Autriche]Source :
- Movement disorders [ 0885-3185 ] ; 2007.
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- Pascal (Inist)
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Abstract
Both diffusion weighted magnetic resonance imaging (DWI) of the basal ganglia and meta-iodobenzylguanidin (MIBG) scintigraphy of the heart have been reported useful in the differential diagnosis of patients with Parkinson's disease (PD) vs. the parkinson variant of multiple system atrophy (MSA-P). Their diagnostic value, however, has never been directly compared in patients with parkinsonism and autonomic dysfunction. We have studied 9 patients with PD and 9 patients with MSA-P matched for age and disease severity. Regional trace of the diffusion tensor values were determined in the putamina. Cardiac MIBG uptake was quantified by comparing regions of interest over heart and mediastinum Heart/Mediastinum (H/M) ratio. Furthermore, all patients underwent tilt testing. PD patients showed significantly lower H/M ratios than normal controls; however, there was considerable overlap between the two patient groups. We did not detect any significant differences of blood pressure response to passive tilt between the two patient groups. Sensitivity of MIBG scintigraphy versus DWI for the differentiation of MSA-P from PD was 55.6% vs. 100%, specificity 88.8% vs. 100%, and area under the curve 0.802 vs. 1.000. Our data suggest that DWI is superior to both tilt table testing and MIBG scintigraphy in the differential diagnosis of PD versus MSA-P.
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MSA-P : A comparison with tilt table testing and heart MIBG scintigraphy</title><author><name sortKey="Kollensperger, Martin" sort="Kollensperger, Martin" uniqKey="Kollensperger M" first="Martin" last="Köllensperger">Martin Köllensperger</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Clinical Department of Neurology, Innsbruck Medical University, Anichstraβe 35</s1><s2>6020 Innsbruck</s2><s3>AUT</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>6020 Innsbruck</wicri:noRegion></affiliation></author><author><name sortKey="Seppi, Klaus" sort="Seppi, Klaus" uniqKey="Seppi K" first="Klaus" last="Seppi">Klaus Seppi</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Clinical Department of Neurology, Innsbruck Medical University, Anichstraβe 35</s1><s2>6020 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Mair</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Clinical Department of Neurology, Innsbruck Medical University, Anichstraβe 35</s1><s2>6020 Innsbruck</s2><s3>AUT</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>6020 Innsbruck</wicri:noRegion></affiliation></author><author><name sortKey="Mueller, Joerg" sort="Mueller, Joerg" uniqKey="Mueller J" first="Joerg" last="Mueller">Joerg Mueller</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Clinical Department of Neurology, Innsbruck Medical University, Anichstraβe 35</s1><s2>6020 Innsbruck</s2><s3>AUT</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>6020 Innsbruck</wicri:noRegion></affiliation></author><author><name sortKey="Sawires, Martin" sort="Sawires, Martin" uniqKey="Sawires M" first="Martin" last="Sawires">Martin Sawires</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Clinical Department of Neurology, Innsbruck Medical University, Anichstraβe 35</s1><s2>6020 Innsbruck</s2><s3>AUT</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>6020 Innsbruck</wicri:noRegion></affiliation></author><author><name sortKey="Scherfler, Christoph" sort="Scherfler, Christoph" uniqKey="Scherfler C" first="Christoph" last="Scherfler">Christoph Scherfler</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Clinical Department of Neurology, Innsbruck Medical University, Anichstraβe 35</s1><s2>6020 Innsbruck</s2><s3>AUT</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>6020 Innsbruck</wicri:noRegion></affiliation></author><author><name sortKey="Schocke, Michael F" sort="Schocke, Michael F" uniqKey="Schocke M" first="Michael F." last="Schocke">Michael F. Schocke</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Radiology I, Innsbruck Medical University, Anichstraβe 35</s1><s2>6020 Innsbruck</s2><s3>AUT</s3><sZ>10 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>6020 Innsbruck</wicri:noRegion></affiliation></author><author><name sortKey="Donnemiller, Eveline" sort="Donnemiller, Eveline" uniqKey="Donnemiller E" first="Eveline" last="Donnemiller">Eveline Donnemiller</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Clinical Department of Neurology, Innsbruck Medical University, Anichstraβe 35</s1><s2>6020 Innsbruck</s2><s3>AUT</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>6020 Innsbruck</wicri:noRegion></affiliation></author><author><name sortKey="Virgolini, Irene" sort="Virgolini, Irene" uniqKey="Virgolini I" first="Irene" last="Virgolini">Irene Virgolini</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Clinical Department of Neurology, Innsbruck Medical University, Anichstraβe 35</s1><s2>6020 Innsbruck</s2><s3>AUT</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>6020 Innsbruck</wicri:noRegion></affiliation></author><author><name sortKey="Wenning, Gregor K" sort="Wenning, Gregor K" uniqKey="Wenning G" first="Gregor K." last="Wenning">Gregor K. Wenning</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Clinical Department of Neurology, Innsbruck Medical University, Anichstraβe 35</s1><s2>6020 Innsbruck</s2><s3>AUT</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>6020 Innsbruck</wicri:noRegion></affiliation></author><author><name sortKey="Poewe, Werner" sort="Poewe, Werner" uniqKey="Poewe W" first="Werner" last="Poewe">Werner Poewe</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Clinical Department of Neurology, Innsbruck Medical University, Anichstraβe 35</s1><s2>6020 Innsbruck</s2><s3>AUT</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ><sZ>9 aut.</sZ><sZ>11 aut.</sZ><sZ>12 aut.</sZ><sZ>13 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>Autriche</country><wicri:noRegion>6020 Innsbruck</wicri:noRegion><placeName><settlement type="city">Innsbruck</settlement><region nuts="2" type="region">Tyrol (Land)</region></placeName><orgName type="university">Université de médecine d'Innsbruck</orgName></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2007">2007</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Comparative study</term><term>Diffusion imaging</term><term>Multiple system atrophy</term><term>Nervous system diseases</term><term>Parkinson disease</term><term>Scintigraphy</term><term>Tilt table</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Système nerveux pathologie</term><term>Parkinson maladie</term><term>Atrophie multisystématisée</term><term>Etude comparative</term><term>Table basculante</term><term>Scintigraphie</term><term>Imagerie de diffusion</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Both diffusion weighted magnetic resonance imaging (DWI) of the basal ganglia and meta-iodobenzylguanidin (MIBG) scintigraphy of the heart have been reported useful in the differential diagnosis of patients with Parkinson's disease (PD) vs. the parkinson variant of multiple system atrophy (MSA-P). Their diagnostic value, however, has never been directly compared in patients with parkinsonism and autonomic dysfunction. We have studied 9 patients with PD and 9 patients with MSA-P matched for age and disease severity. Regional trace of the diffusion tensor values were determined in the putamina. Cardiac MIBG uptake was quantified by comparing regions of interest over heart and mediastinum Heart/Mediastinum (H/M) ratio. Furthermore, all patients underwent tilt testing. PD patients showed significantly lower H/M ratios than normal controls; however, there was considerable overlap between the two patient groups. We did not detect any significant differences of blood pressure response to passive tilt between the two patient groups. Sensitivity of MIBG scintigraphy versus DWI for the differentiation of MSA-P from PD was 55.6% vs. 100%, specificity 88.8% vs. 100%, and area under the curve 0.802 vs. 1.000. Our data suggest that DWI is superior to both tilt table testing and MIBG scintigraphy in the differential diagnosis of PD versus MSA-P.</div></front></TEI><affiliations><list><country><li>Autriche</li></country><region><li>Tyrol (Land)</li></region><settlement><li>Innsbruck</li></settlement><orgName><li>Université de médecine d'Innsbruck</li></orgName></list><tree><country name="Autriche"><noRegion><name sortKey="Kollensperger, Martin" sort="Kollensperger, Martin" uniqKey="Kollensperger M" first="Martin" last="Köllensperger">Martin Köllensperger</name></noRegion><name sortKey="Boesch, Sylvia" sort="Boesch, Sylvia" uniqKey="Boesch S" first="Sylvia" last="Boesch">Sylvia Boesch</name><name sortKey="Donnemiller, Eveline" sort="Donnemiller, Eveline" uniqKey="Donnemiller E" first="Eveline" last="Donnemiller">Eveline Donnemiller</name><name sortKey="Heute, Dirk" sort="Heute, Dirk" uniqKey="Heute D" first="Dirk" last="Heute">Dirk Heute</name><name sortKey="Liener, Claudia" sort="Liener, Claudia" uniqKey="Liener C" first="Claudia" last="Liener">Claudia Liener</name><name sortKey="Mair, Katherina J" sort="Mair, Katherina J" uniqKey="Mair K" first="Katherina J." last="Mair">Katherina J. Mair</name><name sortKey="Mueller, Joerg" sort="Mueller, Joerg" uniqKey="Mueller J" first="Joerg" last="Mueller">Joerg Mueller</name><name sortKey="Poewe, Werner" sort="Poewe, Werner" uniqKey="Poewe W" first="Werner" last="Poewe">Werner Poewe</name><name sortKey="Sawires, Martin" sort="Sawires, Martin" uniqKey="Sawires M" first="Martin" last="Sawires">Martin Sawires</name><name sortKey="Scherfler, Christoph" sort="Scherfler, Christoph" uniqKey="Scherfler C" first="Christoph" last="Scherfler">Christoph Scherfler</name><name sortKey="Schocke, Michael F" sort="Schocke, Michael F" uniqKey="Schocke M" first="Michael F." last="Schocke">Michael F. Schocke</name><name sortKey="Seppi, Klaus" sort="Seppi, Klaus" uniqKey="Seppi K" first="Klaus" last="Seppi">Klaus Seppi</name><name sortKey="Virgolini, Irene" sort="Virgolini, Irene" uniqKey="Virgolini I" first="Irene" last="Virgolini">Irene Virgolini</name><name sortKey="Wenning, Gregor K" sort="Wenning, Gregor K" uniqKey="Wenning G" first="Gregor K." last="Wenning">Gregor K. Wenning</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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