Diffusion tensor imaging and voxel based morphometry study in early progressive supranuclear palsy

• Published in: Journal of neurology, neurosurgery and psychiatry Vol. 77; no. 4; pp. 457 - 463
• Main Authors: Padovani, A, Borroni, B, Brambati, S M, Agosti, C, Broli, M, Alonso, R, Scifo, P, Bellelli, G, Alberici, A, Gasparotti, R, Perani, D
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.04.2006; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Activities of daily living; Aged; Anisotropy; Anterior Thalamic Nuclei - pathology; BADL; basic activities of daily living; Biological and medical sciences; Brain research; CDR; Cerebral Cortex - pathology; cerebrospinal fluid; clinical dementia rating scale; Cognition Disorders - diagnosis; Cognition Disorders - etiology; CSF; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Dementia; Diagnostic and Statistical Manual of Mental Disorders; Diffusion Magnetic Resonance Imaging; diffusion tensor imaging; Disease; DSM-IV; DTI; false discovery rate; FBI; FDR; Female; fourth edition; fractional anisotropy; frontal behavioural inventory; full width at half maximum; FWHM; grey matter; Hippocampus - pathology; Humans; IADL; instrumental activities of daily living; Investigative techniques, diagnostic techniques (general aspects); Magnetic resonance imaging; Male; Medical imaging; Medical sciences; mini-mental state examination; MMSE; MNI; Montreal Neurological Institute; Motor Cortex - pathology; Nervous system; Neuroimaging; Neurological disorders; Neurology; neuropsychiatric inventory; Neuropsychological Tests; NPI; Parkinson's disease; Prefrontal Cortex - pathology; progressive supranuclear palsy; PSP; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Severity of Illness Index; Supranuclear Palsy, Progressive - complications; Supranuclear Palsy, Progressive - pathology; unified Parkinson disease rating scale; UPDRS; VBM; voxel based morphometry; white matter; Diffusion imaging; Nervous system diseases; Diffusion tensor; Morphometry; Voxel
• DOI: 10.1136/jnnp.2005.075713
• ISSN: 0022-3050

Background: A comprehensive characterisation of grey and white matter changes in progressive supranuclear palsy (PSP), the second most common extrapyramidal syndrome after Parkinson disease, is still not available. Objective: To evaluate grey and white matter changes in mild PSP patients by voxel based morphometry (VBM) and diffusion tensor imaging (DTI), respectively. Methods: 14 mild PSP patients and 14 healthy controls entered the study and underwent a clinical and neuropsychological evaluation according with a standardised assessment. Each subject had a structural magnetic resonance imaging (MRI) study. Processing analysis of MRI data was carried out according to optimised VBM and fractional anisotropy was determined. Results: Compared with the controls, in PSP patients VBM analysis showed a significant clusters of reduced grey matter in premotor cortex, frontal operculum, anterior insula, hippocampus, and parahippocampal gyrus, bilaterally. With regard to subcortical brain regions, the pulvinar, dorsomedial and anterior nuclei of the thalamus, and superior and inferior culliculum were affected bilaterally. A bilateral decrease in fractional anisotropy in superior longitudinal fasciculus, anterior part of corpus callosum, arcuate fascicolus, posterior thalamic radiations, and internal capsule, probably involving the cortico-bulbar tracts, was present in PSP patients. Conclusions: These data provide evidence for both grey and white matter degeneration in PSP from the early disease stage. These structural changes suggest that atrophy of cortical and subcortical structures and neurodegeneration of specific fibre tracts contribute to neurological deficits in PSP.