Apparent diffusion coefficient measurements of the middle cerebellar peduncle differentiate the Parkinson variant of MSA from Parkinson's disease and progressive supranuclear palsy
Identifieur interne : 000266 ( Main/Corpus ); précédent : 000265; suivant : 000267Apparent diffusion coefficient measurements of the middle cerebellar peduncle differentiate the Parkinson variant of MSA from Parkinson's disease and progressive supranuclear palsy
Auteurs : Giuseppe Nicoletti ; Raffaele Lodi ; Francesca Condino ; Caterina Tonon ; Francesco Fera ; Emil Malucelli ; David Manners ; Mario Zappia ; Letterio Morgante ; Paolo Barone ; Bruno Barbiroli ; Aldo QuattroneSource :
- Brain [ 0006-8950 ] ; 2006-06-30.
Abstract
Clinical differentiation of parkinsonian syndromes such as the Parkinson variant of multiple system atrophy (MSA-P) and progressive supranuclear palsy (PSP) from Parkinson's disease is difficult in the early stage of the disease. In order to identify objective markers for differential diagnosis, we studied these three groups of patients with diffusion-weighted MRI (DWI). Sixteen MSA-P patients, 16 with PSP, 16 with Parkinson's disease and 15 healthy volunteers were studied. Regional apparent diffusion coefficients (rADC) were determined in different brain regions including basal ganglia, thalamus, white matter, pons and middle cerebellar peduncles (MCPs). rADC calculated in the MCP completely differentiated MSA-P patients (median: 0.93 × 10−3 mm2/s) from PSP patients (median: 0.82 × 10−3 mm2/s, P < 0.001), Parkinson's disease patients (median: 0.79 × 10−3 mm2/s, P < 0.001) and healthy volunteers (median: 0.81 × 10−3 mm2/s, P < 0.001). Other regions considered showed an overlapping among groups. DWI discriminates MSA-P from PSP and Parkinson's disease and healthy volunteers on the basis of MCP rADC values. These in vivo results confirm the pathological findings that the majority of MSA-P patients have moderate or severe degenerative changes not only in the nigrostriatal but also in the olivopontocerebellar systems. Our findings indicate that, in order to substantially contribute to the in vivo differential diagnosis of MSA-P, PSP and Parkinson's disease, rADC measurements should not be limited to the basal ganglia but should also include the MCP.
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DOI: 10.1093/brain/awl166
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>Apparent diffusion coefficient measurements of the middle cerebellar peduncle differentiate the Parkinson variant of MSA from Parkinson's disease and progressive supranuclear palsy</title><author><name sortKey="Nicoletti, Giuseppe" sort="Nicoletti, Giuseppe" uniqKey="Nicoletti G" first="Giuseppe" last="Nicoletti">Giuseppe Nicoletti</name><affiliation><mods:affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</mods:affiliation></affiliation></author><author><name sortKey="Lodi, Raffaele" sort="Lodi, Raffaele" uniqKey="Lodi R" first="Raffaele" last="Lodi">Raffaele Lodi</name><affiliation><mods:affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</mods:affiliation></affiliation></author><author><name sortKey="Condino, Francesca" sort="Condino, Francesca" uniqKey="Condino F" first="Francesca" last="Condino">Francesca Condino</name><affiliation><mods:affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</mods:affiliation></affiliation></author><author><name sortKey="Tonon, Caterina" sort="Tonon, Caterina" uniqKey="Tonon C" first="Caterina" last="Tonon">Caterina Tonon</name><affiliation><mods:affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</mods:affiliation></affiliation></author><author><name sortKey="Fera, Francesco" sort="Fera, Francesco" uniqKey="Fera F" first="Francesco" last="Fera">Francesco Fera</name><affiliation><mods:affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</mods:affiliation></affiliation></author><author><name sortKey="Malucelli, Emil" sort="Malucelli, Emil" uniqKey="Malucelli E" first="Emil" last="Malucelli">Emil Malucelli</name><affiliation><mods:affiliation>Institute of Neurological Sciences, National Research 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Research Council Mangone (Cosenza), Italy</mods:affiliation></affiliation></author><author><name sortKey="Condino, Francesca" sort="Condino, Francesca" uniqKey="Condino F" first="Francesca" last="Condino">Francesca Condino</name><affiliation><mods:affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</mods:affiliation></affiliation></author><author><name sortKey="Tonon, Caterina" sort="Tonon, Caterina" uniqKey="Tonon C" first="Caterina" last="Tonon">Caterina Tonon</name><affiliation><mods:affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</mods:affiliation></affiliation></author><author><name sortKey="Fera, Francesco" sort="Fera, Francesco" uniqKey="Fera F" first="Francesco" last="Fera">Francesco Fera</name><affiliation><mods:affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</mods:affiliation></affiliation></author><author><name sortKey="Malucelli, Emil" sort="Malucelli, Emil" uniqKey="Malucelli E" first="Emil" last="Malucelli">Emil Malucelli</name><affiliation><mods:affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</mods:affiliation></affiliation></author><author><name sortKey="Manners, David" sort="Manners, David" uniqKey="Manners D" first="David" last="Manners">David Manners</name><affiliation><mods:affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</mods:affiliation></affiliation></author><author><name sortKey="Zappia, Mario" sort="Zappia, Mario" uniqKey="Zappia M" first="Mario" last="Zappia">Mario Zappia</name><affiliation><mods:affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</mods:affiliation></affiliation></author><author><name sortKey="Morgante, Letterio" sort="Morgante, Letterio" uniqKey="Morgante L" first="Letterio" last="Morgante">Letterio Morgante</name><affiliation><mods:affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</mods:affiliation></affiliation></author><author><name sortKey="Barone, Paolo" sort="Barone, Paolo" uniqKey="Barone P" first="Paolo" last="Barone">Paolo Barone</name><affiliation><mods:affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</mods:affiliation></affiliation></author><author><name sortKey="Barbiroli, Bruno" sort="Barbiroli, Bruno" uniqKey="Barbiroli B" first="Bruno" last="Barbiroli">Bruno Barbiroli</name><affiliation><mods:affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</mods:affiliation></affiliation></author><author><name sortKey="Quattrone, Aldo" sort="Quattrone, Aldo" uniqKey="Quattrone A" first="Aldo" last="Quattrone">Aldo Quattrone</name><affiliation><mods:affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Brain</title><idno type="ISSN">0006-8950</idno><idno type="eISSN">1460-2156</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2006-06-30">2006-06-30</date><biblScope unit="volume">129</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="2679">2679</biblScope><biblScope unit="page" to="2687">2687</biblScope></imprint><idno type="ISSN">0006-8950</idno></series><idno type="istex">3696355095406E5737C748B60CA5CD90FEBBFFC5</idno><idno type="DOI">10.1093/brain/awl166</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0006-8950</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Clinical differentiation of parkinsonian syndromes such as the Parkinson variant of multiple system atrophy (MSA-P) and progressive supranuclear palsy (PSP) from Parkinson's disease is difficult in the early stage of the disease. In order to identify objective markers for differential diagnosis, we studied these three groups of patients with diffusion-weighted MRI (DWI). Sixteen MSA-P patients, 16 with PSP, 16 with Parkinson's disease and 15 healthy volunteers were studied. Regional apparent diffusion coefficients (rADC) were determined in different brain regions including basal ganglia, thalamus, white matter, pons and middle cerebellar peduncles (MCPs). rADC calculated in the MCP completely differentiated MSA-P patients (median: 0.93 × 10−3 mm2/s) from PSP patients (median: 0.82 × 10−3 mm2/s, P < 0.001), Parkinson's disease patients (median: 0.79 × 10−3 mm2/s, P < 0.001) and healthy volunteers (median: 0.81 × 10−3 mm2/s, P < 0.001). Other regions considered showed an overlapping among groups. DWI discriminates MSA-P from PSP and Parkinson's disease and healthy volunteers on the basis of MCP rADC values. These in vivo results confirm the pathological findings that the majority of MSA-P patients have moderate or severe degenerative changes not only in the nigrostriatal but also in the olivopontocerebellar systems. Our findings indicate that, in order to substantially contribute to the in vivo differential diagnosis of MSA-P, PSP and Parkinson's disease, rADC measurements should not be limited to the basal ganglia but should also include the MCP.</div></front></TEI><istex><corpusName>oup</corpusName><author><json:item><name>Giuseppe Nicoletti</name><affiliations><json:string>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</json:string></affiliations></json:item><json:item><name>Raffaele Lodi</name><affiliations><json:string>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</json:string></affiliations></json:item><json:item><name>Francesca Condino</name><affiliations><json:string>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</json:string></affiliations></json:item><json:item><name>Caterina Tonon</name><affiliations><json:string>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</json:string></affiliations></json:item><json:item><name>Francesco Fera</name><affiliations><json:string>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</json:string></affiliations></json:item><json:item><name>Emil Malucelli</name><affiliations><json:string>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</json:string></affiliations></json:item><json:item><name>David Manners</name><affiliations><json:string>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</json:string></affiliations></json:item><json:item><name>Mario Zappia</name><affiliations><json:string>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</json:string></affiliations></json:item><json:item><name>Letterio Morgante</name><affiliations><json:string>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</json:string></affiliations></json:item><json:item><name>Paolo Barone</name><affiliations><json:string>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</json:string></affiliations></json:item><json:item><name>Bruno Barbiroli</name><affiliations><json:string>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</json:string></affiliations></json:item><json:item><name>Aldo Quattrone</name><affiliations><json:string>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Original Articles</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>diffusion imaging</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>middle cerebellar peduncle</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>multiple system atrophy</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>progressive supranuclear palsy</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item></subject><language><json:string>eng</json:string></language><abstract>Clinical differentiation of parkinsonian syndromes such as the Parkinson variant of multiple system atrophy (MSA-P) and progressive supranuclear palsy (PSP) from Parkinson's disease is difficult in the early stage of the disease. In order to identify objective markers for differential diagnosis, we studied these three groups of patients with diffusion-weighted MRI (DWI). Sixteen MSA-P patients, 16 with PSP, 16 with Parkinson's disease and 15 healthy volunteers were studied. Regional apparent diffusion coefficients (rADC) were determined in different brain regions including basal ganglia, thalamus, white matter, pons and middle cerebellar peduncles (MCPs). rADC calculated in the MCP completely differentiated MSA-P patients (median: 0.93 × 10−3 mm2/s) from PSP patients (median: 0.82 × 10−3 mm2/s, P > 0.001), Parkinson's disease patients (median: 0.79 × 10−3 mm2/s, P > 0.001) and healthy volunteers (median: 0.81 × 10−3 mm2/s, P > 0.001). Other regions considered showed an overlapping among groups. DWI discriminates MSA-P from PSP and Parkinson's disease and healthy volunteers on the basis of MCP rADC values. These in vivo results confirm the pathological findings that the majority of MSA-P patients have moderate or severe degenerative changes not only in the nigrostriatal but also in the olivopontocerebellar systems. Our findings indicate that, in order to substantially contribute to the in vivo differential diagnosis of MSA-P, PSP and Parkinson's disease, rADC measurements should not be limited to the basal ganglia but should also include the MCP.</abstract><qualityIndicators><score>8.284</score><pdfVersion>1.4</pdfVersion><pdfPageSize>612.118 x 792.685 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>6</keywordCount><abstractCharCount>1571</abstractCharCount><pdfWordCount>5450</pdfWordCount><pdfCharCount>35357</pdfCharCount><pdfPageCount>9</pdfPageCount><abstractWordCount>232</abstractWordCount></qualityIndicators><title>Apparent diffusion coefficient measurements of the middle cerebellar peduncle differentiate the Parkinson variant of MSA from Parkinson's disease and progressive supranuclear palsy</title><genre><json:string>research-article</json:string></genre><host><volume>129</volume><pages><last>2687</last><first>2679</first></pages><issn><json:string>0006-8950</json:string></issn><issue>10</issue><genre></genre><language><json:string>unknown</json:string></language><eissn><json:string>1460-2156</json:string></eissn><title>Brain</title></host><categories><wos><json:string>CLINICAL NEUROLOGY</json:string><json:string>NEUROSCIENCES</json:string></wos></categories><publicationDate>2006</publicationDate><copyrightDate>2006</copyrightDate><doi><json:string>10.1093/brain/awl166</json:string></doi><id>3696355095406E5737C748B60CA5CD90FEBBFFC5</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/3696355095406E5737C748B60CA5CD90FEBBFFC5/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/3696355095406E5737C748B60CA5CD90FEBBFFC5/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/3696355095406E5737C748B60CA5CD90FEBBFFC5/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a">Apparent diffusion coefficient measurements of the middle cerebellar peduncle differentiate the Parkinson variant of MSA from Parkinson's disease and progressive supranuclear palsy</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Oxford University Press</publisher><availability><p>OUP</p></availability><date>2006-06-30</date></publicationStmt><notesStmt><note>Abbreviations ADCapparent diffusion coefficient DWIdiffusion-weighted imaging EPIecho planar imaging MCPmiddle cerebellar peduncle MSAmultiple system atrophy PPVpositive predictive values PSPprogressive supranuclear palsy rADCregional ADC ROIregion of interest</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">Apparent diffusion coefficient measurements of the middle cerebellar peduncle differentiate the Parkinson variant of MSA from Parkinson's disease and progressive supranuclear palsy</title><author><persName><forename type="first">Giuseppe</forename><surname>Nicoletti</surname></persName><affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</affiliation></author><author><persName><forename type="first">Raffaele</forename><surname>Lodi</surname></persName><affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</affiliation></author><author><persName><forename type="first">Francesca</forename><surname>Condino</surname></persName><affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</affiliation></author><author><persName><forename type="first">Caterina</forename><surname>Tonon</surname></persName><affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</affiliation></author><author><persName><forename type="first">Francesco</forename><surname>Fera</surname></persName><affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</affiliation></author><author><persName><forename type="first">Emil</forename><surname>Malucelli</surname></persName><affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</affiliation></author><author><persName><forename type="first">David</forename><surname>Manners</surname></persName><affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</affiliation></author><author><persName><forename type="first">Mario</forename><surname>Zappia</surname></persName><affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</affiliation></author><author><persName><forename type="first">Letterio</forename><surname>Morgante</surname></persName><affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</affiliation></author><author><persName><forename type="first">Paolo</forename><surname>Barone</surname></persName><affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</affiliation></author><author><persName><forename type="first">Bruno</forename><surname>Barbiroli</surname></persName><affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</affiliation></author><author><persName><forename type="first">Aldo</forename><surname>Quattrone</surname></persName><affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</affiliation></author></analytic><monogr><title level="j">Brain</title><idno type="pISSN">0006-8950</idno><idno type="eISSN">1460-2156</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2006-06-30"></date><biblScope unit="volume">129</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="2679">2679</biblScope><biblScope unit="page" to="2687">2687</biblScope></imprint></monogr><idno type="istex">3696355095406E5737C748B60CA5CD90FEBBFFC5</idno><idno type="DOI">10.1093/brain/awl166</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2006-06-30</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>Clinical differentiation of parkinsonian syndromes such as the Parkinson variant of multiple system atrophy (MSA-P) and progressive supranuclear palsy (PSP) from Parkinson's disease is difficult in the early stage of the disease. In order to identify objective markers for differential diagnosis, we studied these three groups of patients with diffusion-weighted MRI (DWI). Sixteen MSA-P patients, 16 with PSP, 16 with Parkinson's disease and 15 healthy volunteers were studied. Regional apparent diffusion coefficients (rADC) were determined in different brain regions including basal ganglia, thalamus, white matter, pons and middle cerebellar peduncles (MCPs). rADC calculated in the MCP completely differentiated MSA-P patients (median: 0.93 × 10−3 mm2/s) from PSP patients (median: 0.82 × 10−3 mm2/s, P < 0.001), Parkinson's disease patients (median: 0.79 × 10−3 mm2/s, P < 0.001) and healthy volunteers (median: 0.81 × 10−3 mm2/s, P < 0.001). Other regions considered showed an overlapping among groups. DWI discriminates MSA-P from PSP and Parkinson's disease and healthy volunteers on the basis of MCP rADC values. These in vivo results confirm the pathological findings that the majority of MSA-P patients have moderate or severe degenerative changes not only in the nigrostriatal but also in the olivopontocerebellar systems. Our findings indicate that, in order to substantially contribute to the in vivo differential diagnosis of MSA-P, PSP and Parkinson's disease, rADC measurements should not be limited to the basal ganglia but should also include the MCP.</p></abstract><textClass><keywords scheme="keyword"><list><item><term>Original Articles</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>Keywords</head><item><term>diffusion imaging</term></item><item><term>middle cerebellar peduncle</term></item><item><term>multiple system atrophy</term></item><item><term>progressive supranuclear palsy</term></item><item><term>Parkinson's disease</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2006-06-30">Created</change><change when="2006-06-30">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/3696355095406E5737C748B60CA5CD90FEBBFFC5/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus oup" wicri:toSee="no header"><istex:docType PUBLIC="-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" URI="journalpublishing.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article"><front><journal-meta><journal-id journal-id-type="hwp">brain</journal-id><journal-id journal-id-type="publisher-id">brainj</journal-id><journal-id journal-id-type="pmc">brain</journal-id><journal-title>Brain</journal-title><issn pub-type="epub">1460-2156</issn><issn pub-type="ppub">0006-8950</issn><publisher><publisher-name>Oxford University Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.1093/brain/awl166</article-id><article-categories><subj-group><subject>Original Articles</subject></subj-group></article-categories><title-group><article-title>Apparent diffusion coefficient measurements of the middle cerebellar peduncle differentiate the Parkinson variant of MSA from Parkinson's disease and progressive supranuclear palsy</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Nicoletti</surname><given-names>Giuseppe</given-names></name><xref ref-type="aff" rid="au1">1</xref></contrib><contrib contrib-type="author"><name><surname>Lodi</surname><given-names>Raffaele</given-names></name><xref ref-type="aff" rid="au1">2</xref><xref ref-type="aff" rid="au1">3</xref></contrib><contrib contrib-type="author"><name><surname>Condino</surname><given-names>Francesca</given-names></name><xref ref-type="aff" rid="au1">1</xref></contrib><contrib contrib-type="author"><name><surname>Tonon</surname><given-names>Caterina</given-names></name><xref ref-type="aff" rid="au1">2</xref><xref ref-type="aff" rid="au1">3</xref></contrib><contrib contrib-type="author"><name><surname>Fera</surname><given-names>Francesco</given-names></name><xref ref-type="aff" rid="au1">1</xref></contrib><contrib contrib-type="author"><name><surname>Malucelli</surname><given-names>Emil</given-names></name><xref ref-type="aff" rid="au1">2</xref></contrib><contrib contrib-type="author"><name><surname>Manners</surname><given-names>David</given-names></name><xref ref-type="aff" rid="au1">2</xref></contrib><contrib contrib-type="author"><name><surname>Zappia</surname><given-names>Mario</given-names></name><xref ref-type="aff" rid="au1">4</xref><xref ref-type="aff" rid="au1">7</xref></contrib><contrib contrib-type="author"><name><surname>Morgante</surname><given-names>Letterio</given-names></name><xref ref-type="aff" rid="au1">5</xref></contrib><contrib contrib-type="author"><name><surname>Barone</surname><given-names>Paolo</given-names></name><xref ref-type="aff" rid="au1">6</xref></contrib><contrib contrib-type="author"><name><surname>Barbiroli</surname><given-names>Bruno</given-names></name><xref ref-type="aff" rid="au1">2</xref><xref ref-type="aff" rid="au1">3</xref></contrib><contrib contrib-type="author"><name><surname>Quattrone</surname><given-names>Aldo</given-names></name><xref ref-type="aff" rid="au1">1</xref><xref ref-type="aff" rid="au1">4</xref></contrib><aff id="au1"><sup>1</sup><institution>Institute of Neurological Sciences, National Research Council</institution> <addr-line>Mangone (Cosenza), Italy</addr-line></aff><aff id="au2"><sup>2</sup><institution>Dipartimento di Medicina Clinica e Biotecnologia Applicata D. Campanacci, Universita'di Bologna</institution> <addr-line>Bologna, Italy</addr-line></aff><aff id="au3"><sup>3</sup><institution>Dipartimento dell'Area Radiologica, Policlinico S. Orsola</institution> <addr-line>Bologna, Italy</addr-line></aff><aff id="au4"><sup>4</sup><institution>Institute of Neurology, University Magna Graecia</institution> <addr-line>Catanzaro, Italy</addr-line></aff><aff id="au5"><sup>5</sup><institution>Department of Neuroscience, Psychiatry and Anesthesiology, University of Messina, Policlinico Universitario</institution> <addr-line>Italy</addr-line></aff><aff id="au6"><sup>6</sup><institution>Department of Neurological Sciences, University Federico II</institution> <addr-line>Naples, Italy</addr-line></aff><aff id="au7"><sup>7</sup><institution>Present address: Clinica Neurologica I, Dipartimento di Neuroscienze, Università di Catania</institution> <addr-line>Catania, Italy</addr-line></aff></contrib-group><author-notes><corresp id="cor1">Correspondence to: Raffaele Lodi, MD, Dipartimento di Medicina Clinica e Biotecnologia Applicata “D. Campanacci”, “Universita” di Bologna, Policlinico S. Orsola, Via Massarenti 9, 40138 Bologna, Italy E-mail: <email>raffaele.lodi@unibo.it</email></corresp></author-notes><pub-date pub-type="collection"><month>10</month><year>2006</year></pub-date><pub-date pub-type="epub"><day>30</day><month>6</month><year>2006</year></pub-date><volume>129</volume><issue>10</issue><fpage>2679</fpage><lpage>2687</lpage><history><date date-type="received"><day>05</day><month>1</month><year>2006</year></date><date date-type="rev-recd"><day>22</day><month>5</month><year>2006</year></date><date date-type="accepted"><day>24</day><month>5</month><year>2006</year></date></history><copyright-statement>© The Author (2006). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org</copyright-statement><copyright-year>2006</copyright-year><abstract><p>Clinical differentiation of parkinsonian syndromes such as the Parkinson variant of multiple system atrophy (MSA-P) and progressive supranuclear palsy (PSP) from Parkinson's disease is difficult in the early stage of the disease. In order to identify objective markers for differential diagnosis, we studied these three groups of patients with diffusion-weighted MRI (DWI). Sixteen MSA-P patients, 16 with PSP, 16 with Parkinson's disease and 15 healthy volunteers were studied. Regional apparent diffusion coefficients (rADC) were determined in different brain regions including basal ganglia, thalamus, white matter, pons and middle cerebellar peduncles (MCPs). rADC calculated in the MCP completely differentiated MSA-P patients (median: 0.93 × 10<sup>−3</sup> mm<sup>2</sup>/s) from PSP patients (median: 0.82 × 10<sup>−3</sup> mm<sup>2</sup>/s, <italic>P</italic> < 0.001), Parkinson's disease patients (median: 0.79 × 10<sup>−3</sup> mm<sup>2</sup>/s, <italic>P</italic> < 0.001) and healthy volunteers (median: 0.81 × 10<sup>−3</sup> mm<sup>2</sup>/s, <italic>P</italic> < 0.001). Other regions considered showed an overlapping among groups. DWI discriminates MSA-P from PSP and Parkinson's disease and healthy volunteers on the basis of MCP rADC values. These <italic>in vivo</italic> results confirm the pathological findings that the majority of MSA-P patients have moderate or severe degenerative changes not only in the nigrostriatal but also in the olivopontocerebellar systems. Our findings indicate that, in order to substantially contribute to the <italic>in vivo</italic> differential diagnosis of MSA-P, PSP and Parkinson's disease, rADC measurements should not be limited to the basal ganglia but should also include the MCP.</p></abstract><kwd-group><kwd>diffusion imaging</kwd><kwd>middle cerebellar peduncle</kwd><kwd>multiple system atrophy</kwd><kwd>progressive supranuclear palsy</kwd><kwd>Parkinson's disease</kwd></kwd-group></article-meta><notes><def-list><title>Abbreviations</title><def-item><term>ADC</term><def><p>apparent diffusion coefficient</p></def></def-item><def-item><term>DWI</term><def><p>diffusion-weighted imaging</p></def></def-item><def-item><term>EPI</term><def><p>echo planar imaging</p></def></def-item><def-item><term>MCP</term><def><p>middle cerebellar peduncle</p></def></def-item><def-item><term>MSA</term><def><p>multiple system atrophy</p></def></def-item><def-item><term>PPV</term><def><p>positive predictive values</p></def></def-item><def-item><term>PSP</term><def><p>progressive supranuclear palsy</p></def></def-item><def-item><term>rADC</term><def><p>regional ADC</p></def></def-item><def-item><term>ROI</term><def><p>region of interest</p></def></def-item></def-list></notes></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>Apparent diffusion coefficient measurements of the middle cerebellar peduncle differentiate the Parkinson variant of MSA from Parkinson's disease and progressive supranuclear palsy</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Apparent diffusion coefficient measurements of the middle cerebellar peduncle differentiate the Parkinson variant of MSA from Parkinson's disease and progressive supranuclear palsy</title></titleInfo><name type="personal"><namePart type="given">Giuseppe</namePart><namePart type="family">Nicoletti</namePart><affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Raffaele</namePart><namePart type="family">Lodi</namePart><affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Francesca</namePart><namePart type="family">Condino</namePart><affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Caterina</namePart><namePart type="family">Tonon</namePart><affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Francesco</namePart><namePart type="family">Fera</namePart><affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Emil</namePart><namePart type="family">Malucelli</namePart><affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">David</namePart><namePart type="family">Manners</namePart><affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Mario</namePart><namePart type="family">Zappia</namePart><affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Letterio</namePart><namePart type="family">Morgante</namePart><affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Paolo</namePart><namePart type="family">Barone</namePart><affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Bruno</namePart><namePart type="family">Barbiroli</namePart><affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Aldo</namePart><namePart type="family">Quattrone</namePart><affiliation>Institute of Neurological Sciences, National Research Council Mangone (Cosenza), Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><subject><topic>Original Articles</topic></subject><originInfo><publisher>Oxford University Press</publisher><dateIssued encoding="w3cdtf">2006-06-30</dateIssued><dateCreated encoding="w3cdtf">2006-06-30</dateCreated><copyrightDate encoding="w3cdtf">2006</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract>Clinical differentiation of parkinsonian syndromes such as the Parkinson variant of multiple system atrophy (MSA-P) and progressive supranuclear palsy (PSP) from Parkinson's disease is difficult in the early stage of the disease. In order to identify objective markers for differential diagnosis, we studied these three groups of patients with diffusion-weighted MRI (DWI). Sixteen MSA-P patients, 16 with PSP, 16 with Parkinson's disease and 15 healthy volunteers were studied. Regional apparent diffusion coefficients (rADC) were determined in different brain regions including basal ganglia, thalamus, white matter, pons and middle cerebellar peduncles (MCPs). rADC calculated in the MCP completely differentiated MSA-P patients (median: 0.93 × 10−3 mm2/s) from PSP patients (median: 0.82 × 10−3 mm2/s, P < 0.001), Parkinson's disease patients (median: 0.79 × 10−3 mm2/s, P < 0.001) and healthy volunteers (median: 0.81 × 10−3 mm2/s, P < 0.001). Other regions considered showed an overlapping among groups. DWI discriminates MSA-P from PSP and Parkinson's disease and healthy volunteers on the basis of MCP rADC values. These in vivo results confirm the pathological findings that the majority of MSA-P patients have moderate or severe degenerative changes not only in the nigrostriatal but also in the olivopontocerebellar systems. Our findings indicate that, in order to substantially contribute to the in vivo differential diagnosis of MSA-P, PSP and Parkinson's disease, rADC measurements should not be limited to the basal ganglia but should also include the MCP.</abstract><note>Abbreviations ADCapparent diffusion coefficient DWIdiffusion-weighted imaging EPIecho planar imaging MCPmiddle cerebellar peduncle MSAmultiple system atrophy PPVpositive predictive values PSPprogressive supranuclear palsy rADCregional ADC ROIregion of interest</note><subject><genre>Keywords</genre><topic>diffusion imaging</topic><topic>middle cerebellar peduncle</topic><topic>multiple system atrophy</topic><topic>progressive supranuclear palsy</topic><topic>Parkinson's disease</topic></subject><relatedItem type="host"><titleInfo><title>Brain</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">0006-8950</identifier><identifier type="eISSN">1460-2156</identifier><identifier type="PublisherID">brainj</identifier><identifier type="PublisherID-hwp">brain</identifier><part><date>2006</date><detail type="volume"><caption>vol.</caption><number>129</number></detail><detail type="issue"><caption>no.</caption><number>10</number></detail><extent unit="pages"><start>2679</start><end>2687</end></extent></part></relatedItem><identifier type="istex">3696355095406E5737C748B60CA5CD90FEBBFFC5</identifier><identifier type="DOI">10.1093/brain/awl166</identifier><accessCondition type="use and reproduction" contentType="copyright">© The Author (2006). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. 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