Table 2.
Studies evaluating quantitative advanced brain MR parameters for the differential diagnosis between Parkinson's disease and atypical parkinsonisms.
| Author, year | Magnetic field | Technique | Cohort | Results | Acc/Se/Sp |
|---|---|---|---|---|---|
| Kato et al., 2003 [46] | 1.5 T | Morphometric measurements | PSP = 8; PD = 12; HC = 10 DD (y, M ± SD): PSP = 6.4 ± 6.2; PD = 6.9 ± 7.2 |
↓ area of midbrain tegmentum, inferior colliculus, and pontine tegmentum in PSP versus PD | Not reported |
|
| |||||
| Oba et al., 2005 [47] | 1.5 T | Morphometric measurements | PSP = 21; MSA-P = 25; PD = 23; HC = 31 DD (y, M ± SD): PSP = 2.8 ± 1.3; MSA-P = 7.8 ± 3.8; PD = 6.6 ± 1.9 |
↓ midbrain area in PSP versus PD and MSA-P ↓ pons area in MSA-P versus PD and PSP ↓ midbrain/pons ratio in PSP versus PD and MSA-P |
Se/Sp for PSP diagnosis: midbrain area = 100%/91.3%; midbrain/pons ratio = 100%/100% |
|
| |||||
| Nicoletti et al., 2006 [48] | 1.5 T | Morphometric measurements | MSA-P = 16; PD = 26; HC = 14 DD (y, M ± SD): MSA-P = 5.06 ± 3.38; PD = 5.92 ± 6.46 |
↓ MCP width in MSA-P versus PD | Se/Sp of MCP width for MSA-P diagnosis = 100%/100% |
|
| |||||
| Quattrone et al., 2008 [37] | 1.5 T | Morphometric measurements | PSP = 33; MSA-P = 19; PD = 108; HC = 50 DD (y, M ± SD): PSP = 3.0 ± 1.6; MSA-P = 4.6 ± 3.1; PD = 5.5 ± 4.3 |
↓ midbrain area in PSP versus PD and MSA-P ↓ pons area in MSA-P versus PD and PSP ↓ SCP width in PSP versus PD and MSA-P ↓ MCP width in MSA-P versus PD and PSP ↑ pons/midbrain ratio in PSP versus PD and MSA-P ↑ MCP/SCP ratio in PSP versus PD and MSA-P ↑ MRPI in PSP versus PD and MSA-P |
Se/Sp for PSP diagnosis: pons/midbrain ratio = 90.9%/93.5% (versus PD), 97%/94.7% (versus MSA-P); MCP/SCP ratio = 78.8%/88.9% (versus PD), 93.9%/89.5% (versus MSA-P); MRPI = 100%/100% (versus PD and MSA-P) |
|
| |||||
| Gama et al., 2010 [49] | 1.5 T | Morphometric measurements | PD = 21; MSA-C = 11; MSA-P = 8; PSP = 20 DD (y, M ± SD): PD = 6.0 ± 3.66; MSA-C = 3.9 ± 1.62; MSA-P = 5.0 ± 3.2; PSP = 5.6 ± 2.28 |
↓ midbrain area in PSP and MSA-P versus PD, of PSP versus MSA-C and MSA-P and of MSA-P versus MSA-C ↓ pons area PSP, MSA-P, and MSA-C versus PD, of MSA-C and MSA-P versus PSP ↓ MCP diameter in PSP, MSA-C, and MSA-P versus PD, and MSA-C versus PSP ↓ SCP diameter in PSP and MSA-C vs PD, PSP vs MSA-C and MSA-P |
Acc/Se/Sp of midbrain area in discriminating PD, PSP, and MSA-C: 80.0%/65.5%/93.5%, 96.7%/95.0%/97.5%, and 51.7%/66.7%/93.8%, respectively Acc/Se/Sp of pons area in discriminating PD and MSA-C: 90.0%/80.0%/97.1%, 88.3%/77.5%/100% Acc/Se/Sp of MCP diameter in discriminating PD, PSP, and MSA-C: 85.0%/71.4%/96.9% and 90.0%/66.7%/97.8% Acc/Se/Sp of SCP diameter in discriminating PD and PSP: 80.0%/65.5%/93.5% |
|
| |||||
| Hussl et al., 2010 [50] | 1.5 T | Morphometric measurements | PSP = 22; MSA-P = 26; PD = 75 DD (y, M ± SD): PSP = 2.88 ± 1.94; MSA-P = 4.09 ± 1.79; PD = 7.49 ± 6.89 |
↓ midbrain/pons ratio in PSP versus non-PSP ↑ MRPI in PSP versus non-PSP |
Se/Sp for PSP diagnosis (versus non-PSP): midbrain/pons ratio = 63.6%/92.1%; MRPI = 81.8%/80.2% |
|
| |||||
| Longoni et al., 2011 [51] | 1.5 T | Morphometric measurements | PSP-RS = 10; PSP-P = 10; PD = 25; HC = 24 DD [y, M, SD (range)]: PSP-RS = 3.8 (2.5–7); PSP-P = 5.1 (3–10); PD = 4.9 (1–19) |
↑ pons/midbrain ratio in PSP-RS and PSP-P versus PD ↑ MR parkinsonism index in PSP-RS and PSP versus PD |
Se/Sp for PSP diagnosis: pons/midbrain ratio = 90%/96% (PSP-RS versus PD) and 60%/96% (PSP-P versus PD); MRPI = 100%/92% (PSP-RS versus PD) and 70%/68% (PSP-P versus PD) |
|
| |||||
| Morelli et al., 2011 [52] | 1.5 T | Morphometric measurements | Probable PD = 170; possible PD = 132; PSP = 42; HC = 38 DD [y, M, SD (range)]: probable PD = 7.06 ± 3.9 (3–22); possible PD = 3.06 ± 2.4 (1–10); PSP = 3.57 ± 2.4 (1–15) |
↓ SCP diameter, MCP diameter, midbrain area, pons area, midbrain/pons ratio, and ↑ MRPI in PSP versus PD | Acc/Se/Sp of MRPI in discriminating PSP from possible PD: 99.4%/100%/99.2% Acc/Se/Sp of MRPI in discriminating PSP from probable PD: 99.5%/100%/99.4% |
|
| |||||
| Nair et al., 2013 [53] | 3 T | Morphometric measurements: volumetry-DTI | PD = 26; MSA = 13 DD (m, M ± SD): PD = 8.9 ± 6.5 (range 1–25); MSA = 3.7 ± 2.1 (range 1–7) |
↓ mean width and FA of MCP, anteroposterior diameter and volume of pons, FA and volume of cerebellum, volume of putamen, FA of rostral substantia nigra, and ↑ MD of MCP in MSA versus PD |
Overall performance of the decision tree (including mean MCP width and FA and anteroposterior diameter of pons) was 92% sensitivity, 96% specificity, 92% PPV, and 96% NPV |
|
| |||||
| Zanigni et al., 2016 [54] | 1.5 T | Morphometric measurements: volumetry-DTI | PSP-RS = 23; PD = 42 DD (y, M ± SD): PSP-RS = 4.2 ± 2.7; PD = 4.0 ± 3.3 |
↓ MCP and SCP diameters, pons and midbrain areas and ↑ MCP/SCP diameter, pons/midbrain area, and MRPI in PSP-RS versus PD ↑ MD in SCP, thalamus, putamen, pallidus, parietooccipital and prefrontal WM, brain hemispheres, posterior fossa, brainstem, and cerebellar hemispheres in PSP-RS versus PD ↓ FA in SCP, midbrain (SCPs decussation), parietooccipital and prefrontal WM, brain hemispheres, posterior fossa, and brainstem in PSP-RS versus PD ↓ volume of brainstem, nucleus accumbens, globus pallidus, putamina, thalami, and ↑ volume of lateral ventricles in PSP-RS versus PD |
Acc/Se/Sp of midbrain area in discriminating PSP-RS from PD: 99%/96%/98% Acc/Se/Sp of pons/midbrain area in discriminating PSP-RS from PD: 97%/96%/90% Acc/Se/Sp of MRPI in discriminating PSP-RS from PD: 95%/87%/93% Acc/Se/Sp of posterior fossa MD in discriminating PSP-RS from PD: 90%/80%/83% Acc/Se/Sp of SCP MD in discriminating PSP-RS from PD: 88%/70%/98% Acc/Se/Sp of thalamic volume in discriminating PSP-RS from PD: 83%/73%/90% Acc/Se/Sp of putaminal volume in discriminating PSP-RS from PD: 83%/93%/70% |
|
| |||||
| Schulz et al., 1999 [55] | 1.5 T | Volumetric measurements | PSP = 6; MSA-P = 12; MSA-C = 17; PD = 11; HC = 16 (age matched) DD (y, M ± SEM): PSP = 2.3 ± 0.95; MSA-P 3.42 ± 0.67; MSA-C 3.41 ± 0.57; PD = 6.82 ± 0.7 |
↓ TIV-corrected brainstem volume in PSP, MSA-P, and MSA-C versus HC ↓ TIV-corrected cerebellar volume in MSA-P and MSA-C versus HC ↓ TIV-corrected caudate volume in PSP and MSA-P versus PD and HC ↓ TIV-corrected putaminal volume in PSP and MSA-P versus PD and HC |
Not reported |
|
| |||||
| Cordato et al., 2002 [56] | 1.5 T | Volumetric measurements | PSP = 21; PD = 17; HC = 23 DD (m, M ± SD): PSP = 47.7 ± 34.0; PD = 94.3 ± 35.5 |
↑ ventricular, ↓ whole brain, and frontal GM volumes in PSP versus PD and HC | Se/Sp discriminant function including frontal GM volume in differentiating PSP from PD and HC: 95.2% and 90.9% |
|
| |||||
| Gröschel et al., 2004 [57] | 1.5 T | Volumetric measurements | PSP = 33; CBS = 18; HC = 22 DD (y, M ± SD): PSP = 3.6 ± 2.2; CBS 4.6 ± 1.6 |
↓ brainstem volume (>midbrain) in PSP versus CBS and HC ↓ parietal and occipital lobes volumes (>white matter) in CBS versus PSP and HC ↓ area of CC in CBS versus PSP and HC |
Discriminating capacity of a function including midbrain, parietal WM, temporal GM, brainstem, frontal WM, and pons volumes in differentiating PSP from CBS from HC: 84% (95%, 76%, and 83%, resp.) |
|
| |||||
| Paviour et al., 2005 [58] | 1.5 T | Volumetric measurements | PSP = 19; MSA = 10; PD = 12; HC = 12 DD (y, M ± SD): PSP = 4.6 ± 1.6; MSA = 5.4 ± 1.7; PD = 13.25 ± 6.7 |
↓ TIV-corrected SCP volume in PSP versus MSA, PD, and HC | Se/Sp for PSP diagnosis: 74% and 77% |
|
| |||||
| Paviour et al., 2006 [59] | 1.5 T | Volumetric measurements | PSP = 18; MSA = 9; PD = 9; HC = 18 DD (y, M ± SD): PSP = 4.6 ± 1.6; MSA = 5.4 ± 1.7; PD = 12.9 ± 4.3 |
↓ midbrain and SCP volumes in PSP versus MSA-P, PD, and HC ↓ frontal lobe volume in PSP versus PD and HC ↑ 3rd ventricle volume in PSP versus HC ↓ cerebellar and pontine volumes in MSA-P versus PD and HC ↓ midbrain volume in MSA-P versus HC |
Se/Sp for regression analysis including midbrain, SCPs, frontal lobe, 3rd ventricle, and whole brain volumes in discriminating PSP from MSA-P, PD, and NC: 88.9% and 97.3% Se/Sp of midbrain, SCP, pons, and cerebellar volumes in discriminating PSP from MSA-P: 94.4% and 88.9% |
|
| |||||
| Messina et al., 2011 [60] | 1.5 T | Volumetric measurements | PSP = 32; MSA-P = 15; PD = 72; HC = 46 DD (y, M ± SD): PSP = 3.53 ± 3.5; MSA-P = 3.07 ± 2.2; PD = 6.19 ± 4.5 |
↓ cerebellar cortex, thalamus, putamen, pallidum, hippocampus, and brainstem and ↑ lateral, 3rd and 4th ventricles volumes in PSP versus PD and HC ↓cerebellar cortex, putamen, pallidum, hippocampus, and brainstem and ↑ 4th ventricle volumes in MSA-P versus PD and HC ↓thalamus volume in PSP versus MSA-P |
Not reported |
|
| |||||
| Schocke et al., 2002 [61] | 1.5 T | DWI | MSA-P = 10; PD = 11; HC = 7 DD (y, M ± SD): MSA-P = 2.8 ± 0.9; PD = 2.9 ± 1.1 |
↑ rADC in putamen in MSA-P versus PD | Se/Sp for MSA-P diagnosis: 100%/100% |
|
| |||||
| Seppi et al., 2003 [62] | 1.5 T | DWI | PSP = 10; MSA-P = 12; PD = 13 DD (y, M ± SD): PSP = 2.7 ± 1.1; MSA-P = 2.9 ± 1.1; PD = 3.0 ± 1.2 |
↑ rADC in putamen, caudate, and pallidum in PSP versus PD ↑ rADC in putamen, caudate in MSA-P versus PD |
Se/Sp for MSA-P diagnosis (versus PD): putaminal rADC = 100%/100%. Se/Sp for PSP diagnosis (versus PD): putaminal rADC = 90%/100%. No discrimination between MSA-P and PSP |
|
| |||||
| Schocke et al., 2004 [63] | 1.5 T | DWI | MSA-P = 11; PD = 17; HC = 10 DD (y, M ± SD): MSA-P = 3.9 ± 1.9; PD = 3.7 ± 1.8 |
↑ rTrace(D) in putamen, caudate, and pallidum in MSA-P versus PD | Se/Sp not reported (but no overlap between MSA-P and PD using putaminal rTrace(D)) |
|
| |||||
| Seppi et al., 2004 [64] | 1.5 T | DWI | MSA-P = 15; PD = 17; HC = 10 DD (y, M ± SD): MSA-P = 3.1 ± 1.5; PD = 3.9 ± 0.9 |
↑ rADC in putamen in MSA-P versus PD | Se/Sp for MSA-P diagnosis: 93%/100% (higher compared with [123I]IBZM-SPECT) |
|
| |||||
| Seppi et al., 2006 [65] | 1.5 T | DWI | MSA-P = 15; PD = 20; HC = 11 DD (y, M ± SD): MSA-P = 3.5 ± 2.1; PD = 3.9 ± 1.8 |
↑ rTrace(D) in putamen in MSA-P versus PD | Se/Sp not reported [but no overlap between MSA-P and PD using posterior putaminal rTrace(D)] |
|
| |||||
| Nicoletti et al., 2006 [66] | 1.5 T | DWI | PSP = 16; MSA-P = 16; PD = 16; HC = 15 DD (y, M ± SD): PSP = 3.3 ± 2.5; MSA-P = 4.9 ± 4.0; PD = 7.5 ± 5.8 |
↑ rADC in putamen, caudate, pallidum, thalamus, MCP, and pons in MSA-P versus PD ↑ rADC in putamen, caudate, pallidum, and thalamus in PSP versus PD ↑ rADC in putamen, MCP in MSA-P versus PSP |
Se/Sp for MSA-P diagnosis: MCP rADC = 100%/100% (versus PD and versus PSP); putaminal rADC = 100%/100% (versus PD), 100%/81.2% (versus PSP); pallidal rADC = 62.5%/93.7% (versus PD); caudate rADC = 75%/93.7% (versus PD). Se/Sp for PSP diagnosis (versus PD): putaminal rADC = 75%/100% |
|
| |||||
| Paviour et al., 2007 [67] | 1.5 T | DWI | PSP = 20; MSA-P = 11; PD = 12; HC = 7 DD (y, M ± SD): PSP = 4.5 ± 1.8; MSA = 5.4 ± 1.6; PD = 13.3 ± 6.7 |
↑ rADC in MCP and rostral pons in MSA-P versus PSP and PD | Se/Sp for MSA-P diagnosis (versus PSP and versus PD): MCP rADC = 91%/84% |
|
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| Köllensperger et al., 2007 [68] | n.a. | DWI | MSA-P = 9; PD = 9; HC = 9 DD (y, M ± SD): MSA = 6.4 ± 2.35; PD = 11.3 ± 6.07 |
↑ rTrace(D) in putamen in MSA-P versus PD | Se/Sp for MSA-P diagnosis: 100%/100% (higher compared with tilt test and heart MIBG scintigraphy) |
|
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| Nicoletti et al., 2008 [69] | 1.5 T | DWI | PSP = 28; MSA-P = 15; PD = 15; HC = 16 DD (y, M ± SD): PSP = 3.2 ± 1.7; MSA = 5.1 ± 4.0; PD = 8.6 ± 3.6 |
↑ rADC in SCP in PSP versus PD and versus MSA-P | Se/Sp for PSP diagnosis: 100%/100% (versus PD), 96.4%/93.3% (versus MSA-P). No basal ganglia analysis |
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| Rizzo et al., 2008 [70] | 1.5 T | DWI | PSP-RS = 10; CBS = 7; PD = 13; HC = 9 DD (y, M ± SD): PSP-RS = 4 ± 3; CBS = 4 ± 3; PD = 14 ± 8 |
↑ ADCave in putamen and SCP in PSP-RS versus PD ↑ ADCave in putamen in CBS versus PD ↑ hemispheric median ADCave in CBS versus PD and PSP-RS ↓ HSR in CBS versus PD and PSP-RS |
Se/Sp for PSP-RS diagnosis (versus PD): putaminal ADCave = 80%/77%; SCP ADCave = 90%/85%. Se/Sp for CBS diagnosis: putaminal ADCave = 86%/92% (versus PD); hemispheric median ADCave = 86%/85% (versus PD), 100%/90% (versus PSP-RS); HSR = 100%/100% (versus PD and PSP-RS) |
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| Pellecchia et al., 2009 [71] | 1.5 T | DWI | MSA-P = 9; MSA-C = 12; HC = 11 DD (y, M ± SD): MSA-P = 4.1 ± 1.4; MSA-C = 4.1 ± 2.2 |
↑ trace (D) values in whole and anterior putamen in MSA-P versus MSA-C and HC ↑ trace (D) values in the cerebellum (WM) and MCP in MSA-C versus MSA-P and HC |
|
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| Umemura et al., 2013 [72] | 1.5 T | DWI (and 123I-metaiodobenzylguanidine (MIBG) cardiac scintigram) | PD = 118; MSA-P = 20 DD (y, M ± SD): PD = 6.8 ± 4.9; MSA-P = 3.6 ± 1.8 |
↑ putaminal ADC in MSA-P versus PD | Se/Sp for MSA-P diagnosis by ADC test: 85.0% and 89.0% |
|
| |||||
| Tsukamoto et al., 2012 [73] | 3 T | DWI | PD = 17; PSP = 20; MSA = 25 (5 MSA-P; 20 MSA-C); HC = 18 DD (y, M ± SD): PD = 6.0 ± 3.0; PSP = 4.0 ± 3.0; MSA = 3.4 ± 2.6 |
↑ rADC in midbrain and globus pallidus in PSP versus PD, MSA, and HC ↑ rADC in the SCP and in the head of the caudate nucleus in PSP versus MSA and HC ↑ rADC in pons, middle cerebellar peduncle, cerebellar white matter, and dentate nucleus in MSA versus PD, PSP, and HC ↑ rADC in the posterior putamen in MSA versus PSP ↑ rADC values in the putamen, globus pallidus, and head of caudate nucleus in MSA-P versus MSA-C ↑ rADC in the pons, middle cerebellar peduncle, and cerebellar white matter in MSA-C versus MSA-P |
Not reported |
|
| |||||
| Blain et al., 2006 [74] | 1.5 T | DTI | PSP = 17; MSA = 17 (10 MSA-P and 7 MSA-C); PD = 12; HC = 12 DD (y, M ± SD): PSP = 5.3 ± 2.4; MSA = 5.0 ± 2.3; PD = 6.9 ± 2.0 |
↑ MD in MCP and pons in MSA versus PSP and PD ↓ FA in MCP in MSA versus PSP and PD ↑ MD in decussation of SCP in PSP versus MSA and PD ↓ FA in decussation of SCP in PSP versus PD |
Se/Sp not reported |
|
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| Ito et al., 2007 [75] | 3 T | DTI | MSA = 20 (10 MSA-P and 10 MSA-C); PD = 21; HC = 20 DD (y, M ± SD): MSA = 4 ± 2; PD = 10 ± 8 |
↑ ADC in putamen, pons, and cerebellum in MSA-P versus PD ↓ FA in putamen, pons, and cerebellum in MSA-P versus PD |
Se/Sp for MSA-P diagnosis (versus PD): ADC: putamen = 70%/63.6%, pons = 70%/70%, cerebellum = 60%/87.5%; FA: putamen = 70%/87.5%, pons = 70%/100%, and cerebellum = 70%/63.6% 90% of MSA-P had ↑ ADC and ↓ FA in any of the three areas |
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| Ito et al., 2008 [76] | 1.5 T | DTI/DWI | PSP = 7; PD = 29; HC = 19 DD (y, M ± SD): PSP = 3.5 ± 1.6; PD = 4.8 ± 3.3 |
↑ ADC in CC1 in PSP versus PD and HC and in CC2 in PSP versus PD ↓ FA in CC1 in PSP versus HC and in CC2 in PSP versus PD and HC |
Se/Sp of ADC in CC1 and CC2 in differentiating PSP from PD: 100% and 75.9%, and 49.2% and 82.8%, respectively Se/Sp of FA in CC1 and CC2 in differentiating PSP from PD: 85.7% and 65.5%, and 28.5% and 90.0%, respectively |
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| Chung et al., 2009 [77] | 1.5 T | DWI | PD = 12; MSA-P = 10; HC = 10 DD (m, M ± SD): PD = 30.4 ± 22.03; MSA-P = 23.6 ± 12.82 |
↑ rADC in dorsal putamen and MCP in MSA-P versus PD and HC | Se/Sp rADC in dorsal putamen in differentiating MSA-P from PD: 66.67%/80% Se/Sp rADC in MCP in differentiating MSA-P from PD: 91.67%/100% |
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| Erbetta et al., 2009 [78] | 1.5 T | DTI/DWI | PSP = 9; CBS = 11; HC = 7 DD (y, M ± SD): PSP = 3.8 ± 2.2; CBS = 3.0 ± 1.1 |
↑ ADC in anterior, medial thalamus, and SCP and ↓ FA in anterior cingulum in PSP versus CBS ↑ ADC in precentral and postcentral gyri in CBS versus PSP |
Not reported |
|
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| Focke et al., 2011 [79] | 3 T | DTI | PSP = 9; MSA-P = 10; PD = 12; HC = 13 DD (y, M ± SD): PSP = 2.5 ± 2.3; MSA = 4.5 ± 2.7; PD = 5.8 ± 3.8 |
↑ MD in pallidum and SN in PSP versus PD and in SN in PSP versus MSA-P | Se/Sp not reported. No differences in other basal ganglia and in other groups of patients |
|
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| Boelmans et al., 2010 [80] | 1.5 T | DTI | CBS = 14; PD = 14; HC = 14 DD (m, M ± SD): CBS = 40.9 ± 18.9; PD = 34.8 ± 18.7 |
↑ MD in CC in CBS versus PD and HC ↓ FA in middle-dorsal (sensory) CC in CBS versus PD and HC |
Se/Sp MD in the whole CC in differentiating CBS from PD: 79% both Se/Sp MD in the posterior truncus CC in differentiating CBS from PD: 86% and 71% |
|
| |||||
| Nicoletti et al., 2013 [81] | 1.5 T | DTI | PD = 10; MSA-P = 9; MSA-C = 7; PSP-RS = 17; HC = 10 DD (y, M ± SD): PD = 8.3 ± 2.5; MSA-P = 4.4 ± 1.2; MSA-C = 5.4 ± 1.1; PSP-RS = 5.9 ± 1.8 |
↑ MD infratentorial compartment, brainstem, cerebellar vermis, and hemispheres in MSA-P and MSA-C versus PD and HC ↑ MD infratentorial compartment, brainstem, and cerebellar hemispheres in MSA-P and MSA-C versus PSP-RS ↑ MD infratentorial compartment, brainstem, and cerebellar vermis in PSP-RS versus PD and HC ↑ MD in cerebellar vermis in MSA-C versus MSA-P |
Se/Sp of MD of cerebellar hemispheres in discriminating MSA from other groups: 100%/100% |
|
| |||||
| Prodoehl et al., 2013 [82] | 3 T | DTI | PD = 15; MSA-P = 14; PSP = 12; ET = 14; HC = 17 DD (y, M ± SD): PD = 10.5 ± 7.3; MSA-P = 7.4 ± 4.0; PSP = 10.5 ± 2.5; ET = 28.2 ± 21.0 |
FA of SN, AD of putamen, and MD of dentate in discriminating PD from MSA-P and PSP: AUC = 0.99; Se = 90%; and Sp = 100% FA of SN, RD of SCP, and MCP in discriminating PD from MSA-P: AUC = 0.99; Se = 94%; and Sp = 100% FA of SN, AD of putamen in discriminating PD from PSP: AUC = 0.96; Se = 87%; and Sp = 100% FA of caudate, RD of MCP in discriminating MSA-P from PSP: AUC = 0.97; Se = 90%; and Sp = 100% |
|
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| Baudrexel et al., 2014 [83] | 3 T | DTI/volumetry/FDG-PET | PD = 13; PSP = 8; MSA-P = 11; HC = 6 DD (y, M ± SD): PD = 6.4 ± 6.0; PSP = 2.6 ± 1.6; MSA-P = 3.6 ± 2.2 |
↑ MD in posterior putamen in MSA-P versus PD, PSP, and HC ↑ MD in anterior putamen in MSA-P versus PD ↓ putaminal volume in MSA-P versus PD, PSP, and HC |
AUC/Se/Sp of posterior putamen MD in discriminating MSA-P from PD, PSP, and NC: 89%/72.7%/100% AUC/Se/Sp of putaminal volume in discriminating MSA-P from PD, PSP, and NC: 84%/54.5%/100% |
|
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| Hess et al., 2014 [84] | 3 T | DTI + volumetric | PD = 9; PSP = 5; CBS = 6; HC = 12 DD (y, M ± SD): PD = 8.6 ± 4.2; PSP = 3.8 ± 1.4; CBS = 5.5 ± 1.4 |
↓ thalamic volume in PSP and CBS versus PD and HC ↑ ADC in thalamus in PSP versus PD and HC |
Not reported |
|
| |||||
| Nilsson et al., 2007 [85] | 3 T | Deterministic tractography | PD = 2; MSA = 4; PSP = 3; HC = 2 DD (y, range): PD = 2–10; MSA = 2–6; PSP = 2–6 |
↓ FA and ↑ ADC in MCP in MSA versus PSP, PD, and HC ↓ FA and ↑ ADC in SCP in PSP versus MSA, PD, and HC |
Not reported |
|
| |||||
| Surova et al., 2013 [86] | 3 T | Deterministic tractography | PD = 10; MSA-P = 12; PSP = 16; HC = 16 DD [y, M (range)]: PD = 4.5 (2.0–7.5); MSA-P = 3.0 (2.2–5.0); PSP = 3.5 (2.2–4.0) |
↑ MD, RD, and ↓ FA in CC in PSP versus PD and HC ↓ apparent area coefficient in CG and ↑ MD in CST in PSP versus PD ↑ RD in CST in MSA-P versus PD |
AUC/Se/Sp of CG apparent area coefficient in differentiating PSP from PD: 0.88/87%/80% AUC/Se/Sp of CST MD in differentiating PSP from PD: 0.85/94%/80% AUC/Se/Sp of CC MD in differentiating PSP from PD: 0.85/81%/80% |
|
| |||||
| Rosskopf et al., 2014 [87] | 3 T | DTI/probabilistic tractography | PD = 15; PSP = 15 (7 PSP-RS; 8 PSP-P); HC = 18 DD [y, M (range)]: PD = 4 (1–7); PSP = 3 (2–5) |
↓ FA in areas I, II, and III of CC in PSP versus PD and HC | Not reported |
|
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| Surova et al., 2015 [88] | 3 T | DTI/probabilistic tractography//morphometric and volumetric measurement | PSP = 27; MSA-P = 11; PD = 10; HC = 21 DD [y, median (IR)]: PSP = 3 (2–4); MSA-P = 3 (3–5); PD = 4 (2–7) |
↑ MD in thalamus, ventral anterior, and ventral posterior thalamic nuclei and midbrain in PSP versus MSA-P, PD, and HC ↑ MD in pons and putamen in MSA-P versus PD and HC ↑ MD and ↓ FA of bilateral DRTT in PSP versus MSA-P, PD, and HC ↓ thalamus, putamen, and pallidus volumes and midbrain area in PSP versus MSA-P, PD, and HC in both cohorts ↓ putamen and pallidus volumes in MSA-P versus PD and HC |
Se/Sp of MD of the thalamus, right DRTT, and midbrain in discriminating PSP from PD and MSA-P: 81–77%, 92–81%, and 81-81%, respectively |
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| Meijer et al., 2015 [89] | 3 T | DTI | PD = 30; aPS = 19 (12 MSA-P; 3 PSP; 3 DLB) DD [m, M ± SD]: PD = 21.6 ± 11.9; aPS = 28.4 ± 11.1 |
↑ MD in putamen, left SCP in MSA-P versus PD ↑ MD in midbrain and right SCP in PSP versus MSA-P, DLB, and PD |
Diagnostic accuracy in discriminating aPS from PD = 75% |
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| Eckert et al., 2004 [90] | 1.5 T | MTI | PD = 15; PSP = 10; MSA = 12; HC = 20 DD (y, M ± SD): PD = 5.4 ± 4.0; PSP = 4.2 ± 2.7; MSA = 3.6 ± 1.6; |
↓ MTR of globus pallidus in PSP versus PD, MSA and HC ↓ MTR of putamen in MSA versus PD and HC ↓ MTR in substantia nigra in PD, PSP, and MSA versus HC ↓ MTR in caudate and prefrontal WM in PSP versus HC |
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| von Lewinski et al., 2007 [91] | 1 T | T2∗ | PD = 88; MSA = 52 (47 MSA-P; 5 MSA-C); HC = 29 DD (y, M ± SD): MSA = 4.1 ± 2.0; |
↓ T2∗ signal intensity putamen/caudate and putamen/thalamus in MSA versus PD and HC | Se/Sp signal intensity putamen/caudate in discriminating MSA from PD: 65%/95% |
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| Gupta et al., 2010 [92] | 1.5 T | SWI (semiquantitative hypointensity score) |
PD = 11; PSP = 12; MSA-P = 12; HC = 11 DD (y, M ± SD): PD = 8.1 ± 3.9; PSP = 3.5 ± 3.9; MSA-P = 5.4 ± 3.3 |
↓ signal intensity of red nucleus, substantia nigra in PSP versus MSA-P PD and HC ↓ signal intensity in posterolateral putamen in PSP versus PD |
Se/Sp of red nucleus hypointensity score in differentiating PSP from PD and from MSA-P: 66.7%/81.8%–66.7%/83.3% Se/Sp of putamen hypointensity score in differentiating PSP from PD: 50.0%/90.9% |
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| Boelmans et al., 2012 [93] | 1.5 T | Quantitative T2, T2∗, and T2′ | PD = 30; PSP = 12; HC = 24 DD [y, M ± SD (range)]: PD = 9.7 ± 5.2 (0.6–22.7); PSP = 4.5 ± 3.7 (0.7–10.3) |
↓ T2′ time in caudate, globus pallidus, and putamen in PSP versus PD and HC | Classification of linear discriminant analysis including basal ganglia and thalamus: 74.2% |
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| Wang et al., 2012 [94] | 1.5 T | SWI | PD = 16; MSA-P = 8; HC = 44 DD (y, M ± SD): PD = 2.5 ± 1.7; MSA-P = 2.3 ± 1.1 |
↑ (phase shift values) iron content in putamen and thalamus in MSA-P versus PD | Acc of high iron percentage in putamen in discriminating MSA-P from PD: 0.88 |
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| Han et al., 2013 [95] | 3 T | SWI | PD = 15; PSP = 11; MSA-P = 12; HC = 20 DD (m, M ± SD): PD = 30.3 ± 19.10; PSP = 25.6 ± 11.57; MSA-P = 26.4 ± 6.24 |
↑ (phase shift values) iron content in the red nucleus, putamen, globus pallidus, and thalamus in PSP versus PD ↑ (phase shift values) iron content in the red nucleus and putamen in MSA-P versus PD ↑ (phase shift values) iron content in substantia nigra in PD versus MSA-P and HC |
AUC of putamen in discriminating MSA-P from PSP and PD: 0.836 AUC of globus pallidus and thalamus in discriminating PSP from MSA-P and PD: 0.869 and 0.884, respectively |
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| Lee et al., 2013 [96] | 3 T | R2∗/volumetry | PD = 29; PSP = 13; MSA-P = 15 DD (m, M ± SD): PD = 29.41 ± 22.2; PSP = 27.62 ± 15.5; MSA-P = 22.73 ± 8.7; |
↑ R2∗ in the putamen in MSA-P versus PD and HC ↑ R2∗ in globus pallidus and caudate in PSP versus PD and HC ↑ R2∗ in caudate nucleus in PSP versus MSA-P ↓ volume of caudate, putamen, globus pallidus, and thalamus in PSP and MSA-P versus PD and HC ↓ volume of globus pallidus in PSP versus MSA-P ↓ volume of putamen in MSA-P versus PSP |
AUC of putaminal volume in discriminating MSA-P from PSP and PD: 0.832 AUC of globus pallidus volume in discriminating PSP from MSA-P and PD: 0.856 |
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| Yoon et al., 2015 [97] | 3 T | SWI | PD = 30; MSA-P = 17 DD [y, M ± SD (range)]: PD = 6.07 ± 4.93 (1–21); MSA-P = 2.18 ± 1.19 (1–4.5) |
↓ signal intensity of bilateral posterior halves, mean values of the anterior and posterior halves, and the dominant-side posterior half of the putamen in MSA-P versus PD |
AUC of signal intensity of the dominant-side posterior half of the putamen in discriminating MSA-P from PD: 0.947 |
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| Davie et al., 1995 [98] | 1.5 T |
1H-MRS Single-voxel |
PD = 9; MSA-P = 7; MSA-C = 5; HC = 9 | ↓ NAA/Cr and ↓ Cho/Cr in lenticular nucleus in MSA-P versus HC ↓ NAA/Cr in lenticular nucleus in MSA-C versus HC |
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| Federico et al., 1997 [99] | 1.5 T |
1H-MRS Single-voxel |
PD = 8; PSP = 5; HC = 9 DD [y, M (range)]: PD = 7 (4–12); PSP = 5 (3–8) |
↓ NAA/Cr and ↓ NAA/Cho in lenticular nucleus in PSP versus HC | Not reported |
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| Federico et al., 1997 [100] | 1.5 T |
1H-MRS Single-voxel |
PD = 12; PSP = 7; MSA = 7; HC = 10 DD [y, M ± SD (range)]: PD = 5.6 ± 2.6 (3–12); MSA = 3.7 ± 1.6 (3–6) |
↓ NAA/Cho and ↓ NAA/Cr in lenticular nucleus in PSP and MSA versus HC | Not reported |
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| Tedeschi et al., 1997 [101] | 1.5 T |
1H-MRS Single-voxel |
PD = 10; PSP = 12; CBS = 9; HC = 11 DD (m, M ± SD): PD = 103 ± 9; PSP = 48 ± 9; CBS = 40 ± 5 |
↓ NAA/Cr in brainstem, centrum semiovale, and precentral cortices and ↓ NAA/Cho in lenticular nucleus in PSP versus HC ↓ NAA/Cr in centrum semiovale and ↓ NAA/Cho in lenticular nucleus and parietal cortex in CBS versus HC |
Not reported |
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| Federico et al., 1999 [102] | 1.5 T |
1H-MRS Single-voxel |
PD = 19; PSP = 11; MSA = 14; HC = 12 | ↓ NAA/Cho in lenticular nucleus in PSP and MSA versus PD and HC ↓ NAA/Cr in lenticular nucleus in PD, PSP, and MSA versus HC and in MSA versus PD |
Not reported |
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| Abe et al., 2000 [103] | 1.5 T |
1H-MRS Single-voxel |
PD = 23; PSP = 12; MSA = 18; CBS = 19; VP = 10; HC = 20 DD (y, M ± SD): PD = 3.6 ± 1.5; PSP = 3.9 ± 1.6; MSA = 4.0 ± 1.5; CBS = 3.6 ± 1.7; VP = 3.4 ± 1.7 |
↓ NAA/Cr of frontal cortex in PSP, MSA, CBD, and VP versus HC ↓ NAA/Cr of putamen in PSP, MSA, CBD, and PD versus HC ↓ NAA/Cr of frontal cortex and putamen in CBD versus PD, MSA, and VP ↓ NAA/Cr of putamen in PSP versus VP and MSA |
Not reported |
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| Clarke and Lowry, 2000 [104] | 1.5 T |
1H-MRS Single-voxel |
PD = 6; MSA = 6; HC = 6 | ↓ NAA/Cho and ↑ Cho/Cr in lenticular nucleus in PD versus HC | Not reported |
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| Watanabe et al., 2004 [105] | 3 T |
1H-MRS Single-voxel |
24 MSA = 24 (13 MSA-C and 11 MSA-P); PD = 11; HC = 18 DD (y, M ± SD): MSA = 3.7 ± 2.4; PD = 4.4 ± 2.2 |
↓ NAA/Cr of pontine base in all MSA types and of putamen in MSA-P versus HC ↓ NAA/Cr of pontine base and putamen in MSA-P versus PD |
Not reported |
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| Vasconcellos et al., 2009 [106] | 1.5 T |
1H-MRS (Single-voxel) |
PD = 12; PSP = 11; MSA-P = 7; HC = 10 DD (y, M ± SD): PD = 8.5 ± 3.5; PSP = 6.6 ± 3.1; MSA-P = 8.0 ± 2.0 |
↓ NAA/Cr of lenticular nucleus in PSP versus PD and HC ↓ NAA/Cr of the hippocampus in PSP versus HC ↓ NAA/Cho of the midbrain in PSP versus MSA-P and HC |
Not reported |
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| Guevara et al., 2010 [107] | 1.5 T |
1H-MRS (Multi- and single-voxel) |
PD = 11; PSP = 13; MSA-P = 11; MSA-C = 6; HC = 18 DD [y, M ± SD (range)]: PD = 6.9 ± 2.1 (3.9–10.5); PSP = 5.1 ± 2.1 (2.3–10.5); MSA-P = 4.7 ± 2.6 (2.0–9.6); MSA-C = 6.1 ± 2.1 (4.0–9.0) |
↓ NAA of putamen and pallidum in MSA-P and PSP versus PD and HC ↓ NAA of pallidum in PSP versus MSA-P |
Not reported |
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| Zanigni et al., 2015 [108] | 1.5 T |
1H-MRS (Single-voxel) |
PSP-RS = 21; MSA-P = 7; MSA-C = 8; PD = 21; HC = 14 DD [y, median (range)]: PSP-RS = 4 (1–11); MSA-P = 3(0.2–7); MSA-C = 6 (3–13); PD = 3 (1–15) |
↓ cerebellar NAA/Cr and NAA/mI ratios in aPS versus PD and HC and in MSA-C versus PSP-RS, MSA-P, and PD (p < 0.01) ↓ cerebellar NAA/Cr ratio in PSP-RS versus PD and NC (p < 0.05) and ↓ cerebellar NAA/mI in PSP-RS versus NC (p < 0.01) |
Se/Sp of cerebellar NAA/Cr ratio value in discriminating PD from aPS: 100% and 64%. |
Acc/Se/Sp: accuracy/sensitivity/specificity; T: Tesla; PSP: Progressive Supranuclear Palsy; PD: Parkinson's disease; HC: healthy controls; DD: disease duration; y: years; M: mean; SD: standard deviation; MSA: Multiple System Atrophy; MSA-P: parkinsonian variant of MSA; MCP: middle cerebellar peduncle; SCP: superior cerebellar peduncle; MRPI: MR parkinsonism index; MSA-C: cerebellar variant of MSA; PSP-RS: PSP-Richardson's syndrome; PSP-P: PSP-parkinsonism; m: months; FA: fractional anisotropy; MD: mean diffusivity; TIV: total intracranial volume; SEM: standard error mean; CBS: corticobasal syndrome; CC: corpus callosum; WM: white matter; DWI: diffusion-weighted imaging; rADC: regional ADC; rTrace(D): trace of diffusion tensor; ADCave: ADC average; HSR: hemispheric symmetry ratio; ADC: apparent diffusion coefficient; GRE: gradient echo; DTI: diffusion tensor imaging; IR: interquartile range; aPS: atypical parkinsonian syndromes; DLB: dementia with Lewy bodies; MTRI: magnetization transfer imaging; MTR: magnetization transfer; SWI: susceptibility-weighted imaging; AUC: area under the curve; 1H-MRS: proton magnetic resonance spectroscopy; NAA: N-acetyl-aspartate; Cr: creatine; Cho: choline; VP: vascular parkinsonism.