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Diffusion tensor imaging differentiates vascular parkinsonism from parkinsonian syndromes of degenerative origin in elderly subjects 
Auteur(s): Deverdun J., de Champfleur Sophie Menjot, Cabello-Aguilar Simon, Maury Florence, Molino F., Charif Mahmoud, Leboucq Nicolas, Ayrignac Xavier, Labauge Pierre, Bonafe Alain, Castelnovo Giovanni, Le Bars E., Geny Christian, Menjot De Champfleur N.
(Article) Publié:
European Journal Of Radiology, vol. 83 p.2074-2079 (2014)
Ref HAL: hal-01157884_v1
PMID 25154005
DOI: 10.1016/j.ejrad.2014.07.012
WoS: 000343110500012
Exporter : BibTex | endNote
10 Citations
Résumé: Background and PurposeThe etiologic diagnosis of parkinsonian syndromes is of particular importance when considering syndromes of vascular or degenerative origin. The purpose of this study is to find differences in the white-matter architecture between those two groups in elderly patients.Materials and MethodsThirty-five patients were prospectively included (multiple-system atrophy, n = 5; Parkinson's disease, n = 15; progressive supranuclear palsy, n = 9; vascular parkinsonism, n = 6), with a mean age of 76 years. Patients with multiple-system atrophy, progressive supranuclear palsy and Parkinson's disease were grouped as having parkinsonian syndromes of degenerative origin. Brain MRIs included diffusion tensor imaging. Fractional anisotropy and mean-diffusivity maps were spatially normalized, and group analyses between parkinsonian syndromes of degenerative origin and vascular parkinsonism were performed using a voxel-based approach.ResultsStatistical parametric-mapping analysis of diffusion tensor imaging data showed decreased fractional anisotropy value in internal capsules bilaterally in patients with vascular parkinsonism compared to parkinsonian syndromes of degenerative origin (p = 0.001) and showed a lower mean diffusivity in the white matter of the left superior parietal lobule (p = 0.01).Fractional anisotropy values were found decreased in the middle cerebellar peduncles in multiple-system atrophy compared to Parkinson's disease and progressive supranuclear palsy. The mean diffusivity was increased in those regions for these subgroups.ConclusionClinically defined vascular parkinsonism was associated with decreased fractional anisotropy in the deep white matter (internal capsules) compared to parkinsonian syndromes of degenerative origin. These findings are consistent with previously published neuropathological data.
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