Back to Journals » Neuropsychiatric Disease and Treatment » Volume 12

Diffusion tensor imaging in the characterization of multiple system atrophy

Authors Rulseh A, Keller J, Rusz J, Syka M, Brozova H, Rusina R, Havrankova P, Zarubova K, Malikova H, Jech R, Vymazal J

Received 24 March 2016

Accepted for publication 26 May 2016

Published 26 August 2016 Volume 2016:12 Pages 2181—2187

DOI https://doi.org/10.2147/NDT.S109094

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Prof. Dr. Roumen Kirov

Peer reviewer comments 2

Editor who approved publication: Dr Roger Pinder


Aaron Michael Rulseh,1–3 Jiri Keller,1,4 Jan Rusz,5,6 Michael Syka,1 Hana Brozova,6 Robert Rusina,6,7 Petra Havrankova,6 Katerina Zarubova,8 Hana Malikova,1 Robert Jech,6 Josef Vymazal1

1Department of Radiology, Na Homolce Hospital, Prague, Czech Republic; 2Department of Radiology, 1st Faculty of Medicine, General University Hospital, Charles University in Prague, Prague, Czech Republic; 3National Institute of Mental Health, Klecany, Czech Republic; 43rd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic; 5Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic; 6Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic; 7Thomayer Hospital, Prague, Czech Republic; 8Department of Neurology, 2nd Faculty of Medicine, Charles University in Prague, Prague, Czech Republic

Purpose: Multiple system atrophy (MSA) is a rare neurodegenerative disease that remains poorly understood, and the diagnosis of MSA continues to be challenging. We endeavored to improve the diagnostic process and understanding of in vivo characteristics of MSA by diffusion tensor imaging (DTI).
Materials and methods: Twenty MSA subjects, ten parkinsonian dominant (MSA-P), ten cerebellar dominant (MSA-C), and 20 healthy volunteer subjects were recruited. Fractional anisotropy, mean diffusivity, radial diffusivity, and axial diffusivity maps were processed using tract-based spatial statistics. Diffusion data were additionally evaluated in the basal ganglia. A support vector machine was used to assess diagnostic utility, leave-one-out cross-validation in the evaluation of classification schemes, and receiver operating characteristic analyses to determine cutoff values.
Results: We detected widespread changes in the brain white matter of MSA subjects; however, no group-wise differences were found between MSA-C and MSA-P subgroups. Altered DTI metrics in the putamen and middle cerebellar peduncles were associated with a positive parkinsonian and cerebellar phenotype, respectively. Concerning clinical applicability, we achieved high classification performance on mean diffusivity data in the combined bilateral putamen and middle cerebellar peduncle (accuracy 90.3%±9%, sensitivity 86.5%±11%, and specificity 99.3%±4%).
Conclusion: DTI in the middle cerebellar peduncle and putamen may be used in the diagnosis of MSA with a high degree of accuracy.

Keywords: multiple system atrophy, diffusion tensor imaging, magnetic resonance imaging, neuroimaging, diagnostic imaging

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]