Table 3.
Anatomical distribution of brain alterations in multiple system atrophy (MSA), in the cerebellar (-C) and parkinsonian (-P) MSA variants, in progressive supranuclear palsy (PSP), and in corticobasal syndrome (CBS) (results of those studies focused on the differential diagnosis between Parkinson's disease and atypical parkinsonian syndromes).
| MSA | MSA-C | MSA-P | PSP | CBS | |
|---|---|---|---|---|---|
| Basal ganglia | |||||
|
| |||||
| Putamen | ↓ volume∗ [53] ↑ ADC∧ [73] ↓ MTR∗† [90] ↓ T2∗ signal intensity∗† [91] ↓ NAA/Cr† [103] |
↓ volume∗∧† [55, 60, 83, 86, 96] ↑ ADC∗°§† [61, 62, 64, 66, 73, 75, 77] ↑ rTrace(D)∗§† [63, 65, 68, 71] ↓ FA∗ [75] ↑ MD∗∧† [83, 86, 89] ↑ phase shift values∗ [94, 95] ↑ R2∗ signal intensity∗† [96] ↓ SWI signal intensity∗ [97] ↓ NAA/Cr∗† [105] ↓ NAA∗† [107] |
↓ volume∗°† [54, 55, 60, 86, 96] ↑ ADC∗ [62, 66, 70, 72] ↓ T2′ time∗† [93] ↑ MD∗ [54] ↓ SWI signal intensity∗ [92] ↑ phase shift values∗ [95] ↓ NAA/Cr#† [103]↓ NAA∗† [107] |
↑ ADC∗ [70] ↓ NAA/Cr∗#† [103] |
|
|
| |||||
| Globus pallidus | ↓ volume∗† [60, 86, 96] ↑ rTrace(D)∗ [63] ↑ ADC∗§ [66, 73] ↓ NAA∗† [107] |
↓ volume∗°† [54, 60, 86, 96] ↑ ADC∗#† [62, 66, 73] ↑ MD∗ [54, 79] ↓ MTR∗#† [90] ↓ T2′ time∗† [93] ↑ phase shift values∗ [95] ↑ R2∗ signal intensity∗† [96] ↓ NAA∗°† [107] |
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|
| |||||
| Lenticular nucleus | ↓ NAA/Cr∗† [100, 102] ↓ NAA/Cho∗† [100, 102] |
↓ NAA/Cr† [98] | ↓ NAA/Cr† [98] ↓ Cho/Cr† [98] |
↓ NAA/Cr∗† [99–102, 109] ↓ NAA/Cho∗† [99, 100, 102] |
↓ NAA/Cho† [101] |
|
| |||||
| Caudate | ↓ volume∗† [55, 96] ↑ ADC∗§ [62, 66, 73] ↑ rTrace(D)∗ [63] |
↓ volume∗† [55, 96] ↑ ADC∗#† [62, 66, 73] ↓ MTR† [90] ↓ T2′ time∗† [93] ↑ R2∗ signal intensity∗°† [96] |
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|
| |||||
| Nucleus accumbens | ↓ volume∗ [54] | ||||
|
| |||||
| Thalamus | ↑ ADC∗ [66] ↑ phase shift values∗ [94] ↓ volume∗ [96] |
↓ volume∗°† [54, 60, 84, 86, 96] ↑ ADC∗λ† [66, 78] ↑ MD∗°† [54, 86] ↑ phase shift values∗ [95] |
↓ volume∗† [84] | ||
|
| |||||
| Supratentorial compartment | |||||
|
| |||||
| Whole brain | ↓ volume∗† [56] ↑ MD∗ [54] ↓ FA∗ [54] |
↑ ADC∗∧ [70] ↓ HSR∗∧ [70] |
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|
| |||||
| Frontal lobe | ↓ NAA/Cr† [103] | ↓ volume∗† [56, 59] ↑ MD∗ [54] ↓ FA∗ [54] ↓ MTR† [90] ↓ precentral cortices NAA/Cr† [101] ↓ NAA/Cr† [103] |
↑ ADC precentral gyrus∧ [78] ↓ NAA/Cr∗#† [103] |
||
|
| |||||
| Parietal lobe | ↑ MD∗ [54] ↓ FA∗ [54] |
↓ volume∧† [57] ↑ ADC postcentral gyrus∧ [78] ↓ NAA/Cho† [101] |
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|
| |||||
| Occipital lobe | ↓ volume∧† [57] | ||||
|
| |||||
| Corpus Callosum | ↑ ADC in CC1∗† and CC2∗ [76] ↓ FA in CC1† and CC2∗† [76] ↑ MD∗† [86] ↑ RD∗† [86] ↓ FA∗† [86, 87] |
↓ area∧† [57] ↑ MD∗† [80] ↓ FA∗† [80] |
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|
| |||||
| Cingulate gyrus | ↑ ADCλ anterior CG [78] ↓ apparent area coefficient∗ [86] |
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|
| |||||
| Hippocampus | ↓ volume∗† [60] | ↓ volume∗† [60] ↓ NAA/Cr† [107] |
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|
| |||||
| Centrum semiovale | ↓ NAA/Cr† [101] | ||||
|
| |||||
| Lateral ventricles | ↑ volume∗† [54, 56, 60] | ||||
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| |||||
| 3rd ventricle | ↑ volume∗† [59, 60] | ||||
|
| |||||
| 4th ventricle | ↑ volume∗† [60] | ↑ volume∗† [60] | |||
|
| |||||
| White matter tracts | |||||
|
| |||||
| CST | ↑ RD [86] | ↑ MD∗ [86] | |||
|
| |||||
| DRTT | ↑ MD∗°† [88] ↓ FA∗°† [88] |
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|
| |||||
| Infratentorial compartment | |||||
|
| |||||
| Whole | ↓ volume† [54] ↑ MD∗∧† [81] |
↓ volume† [54] ↑ MD∗∧† [81] |
↓ volume∗λ† [55, 57, 60] ↑ MCP/SCP∗° [37, 54] ↓ M/P∗° [47, 50, 52] ↑ P/M∗° [37, 54] ↑ MRPI∗° [37, 50, 52, 54] ↑ MD∗† [54, 81] ↓ FA∗ [54] |
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|
| |||||
| Midbrain | ↓ area∗§ [49] ↓ volume† [59] |
↓ area∗°§† [37, 46, 47, 49, 52, 54, 88] ↓ volume∗°† [59] ↑ ADC∗#† [73] ↑ MD∗°† [88, 89] ↓ FA∗ [54] ↓ NAA/Cho°† [106] |
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|
| |||||
| Substantia Nigra | ↓ FA∗ [53] ↓ MTR† [90] |
↑ MD∗° [79] ↓ MTR† [90] ↓ SWI signal intensity∗°† [92] |
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|
| |||||
| Red nucleus | ↑ phase shift values∗ [95] | ↑ phase shift values∗ [95] ↓ SWI signal intensity∗°† [92] |
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|
| |||||
| Pons | ↓ anteroposterior diameter∗ [53] ↓ volume∗ [53] ↑ ADC∗∧† [73] ↓ NAA/Cr† [105] |
↓ area∗∧ [49] ↑ MD∗∧ [74] |
↓ area∗∧ [37, 47, 49] ↓ volume∗† [59] ↑ ADC∗∧ [55, 59, 75] ↓ FA∗ [75] ↑ MD∗† [88] ↓ NAA/Cr∗ [105] |
↓ area∗ [46, 49, 52, 54] | |
|
| |||||
| Brainstem | ↓ volume† [55] ↑ MD∗∧† [81] |
↓ volume∗† [55, 60] ↑ MD∗∧† [81] |
↑ MD∗† [54, 55, 81] ↓ FA∗ [54] ↓ volume∗ [54] ↓ NAA/Cr† [101] |
||
|
| |||||
| SCP | ↓ diameter∗ [49] | ↑ MD∗ [89] | ↓ width∗° [37] ↓ diameter∗°§ [49, 52, 54] ↓ volume∗#† [59] ↑ ADC∗°λ† [69, 70, 73, 78] ↑ MD∗#° [54, 74, 89] ↓ FA∗ [54, 74] |
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|
| |||||
| MCP | ↓ mean width∗ [53] ↑ MD∗∧ [53, 74] ↓ FA∗∧† [53, 74, 85] ↑ ADC∗∧† [73, 85] |
↓ diameter∗∧ [49] ↑ trace(D)°† [71] |
↓ width∗° [37, 48] ↓ diameter∗ [49] ↑ ADC∗∧† [48, 67, 77] |
↓ diameter∗ [49, 52, 54] ↓ FA∗#† [85] ↑ ADC∗#† [85] |
|
|
| |||||
| Cerebellum | ↓ volume∗ [53] ↑ ADC∗∧† [73] ↓ FA∗ [53] |
↓ volume† [54] ↑ trace(D)°† [71] |
↓ volume∗† [54, 59, 60] ↑ ADC∗ [75] ↓ FA∗ [75] |
↓ volume (cortex)∗† [60] | |
|
| |||||
| Cerebellar vermis | ↑ MD∗°† [81] | ↑ MD∗† [81] | ↑ MD∗† [81] | ||
|
| |||||
| Cerebellar hemispheres | ↑ MD∗∧† [81] ↓ NAA/Cr∗∧° [108] |
↑ MD∗∧† [81] | ↑ MD∗ [54] ↓ NAA/Cr∗† [108] ↓ NAA/mI† [108] |
||
ADC: apparent diffusion coefficient; MTR: magnetization transfer; rTrace(D): trace of diffusion tensor; NAA: N-acetyl-aspartate; CR: creatine; FA: fractional anisotropy; MD: mean diffusivity; SWI: susceptibility weighted imaging; HSR: hemispheric symmetry ratio; Cho: choline; CC: corpus callosum; RD: radial diffusivity; CST: corticospinal tract; DRTT: dentatorubrothalamic-tract; MCP: middle cerebellar peduncle; SCP: superior cerebellar peduncle; M: midbrain; P: pons; MRPI: MR parkinsonism index.
∗versus PD; ∧versus PSP; °versus MSA-P; §versus MSA-C; #versus MSA; λversus CBS; †versus HC.