Table 5.
Diagnostic accuracy of MR finding implemented on higher field MR systems (3.0 or 7.0 T) in PD
| Reference | Cohort size | Main results | Discriminator | Accuracy, % |
|---|---|---|---|---|
| Iron-sensitive sequences | ||||
| Baudrexel et al. (2010) | PD 20/HC 20 | Decreased T2* in SN bilateral Decreased T1 in SN controlateral |
Decreased T1 in SN | Se 71 Sp 80 AUC = 0.75 |
| Mahlknecht et al. (2017) (in press) | Meta-analysis including 364 patients with PD and 231 controls from 10 studies | Absence of DNH more common in PD than controls | Absence of DNH | Se 98 Sp 95 |
| Multimodal imaging | ||||
| Menke et al. (2009) | PD 10/HC 10 | Decreased SN volume Decreased VCDR Decreased SN volume + decreased VCDR |
Combined SN volumetry with DTI of SN | Se 100 Sp 80 |
| Peran et al. (2010) | PD 30/HC 22 | Increased R2* in the SN Reduced FA in the SN Increased mean diffusivity in the putamen or caudate nucleus |
Multimodal MRI study at 3.0 T using a combination of different MR markers including volumetry, mean R2*, mean diffusivity and FA applied in 6 deep grey matter structures (SN, red nucleus, thalamus, putamen, caudate, pallidum) | Combinations of three markers achieved a maximum AUC = 0.98 Combinations of four markers achieved a maximum AUC = 0.99 |
| Du et al. (2011) | PD 16/HC 16 | Better discrimination of combined use of transverse relaxation rate and FA values in the SN compared to transverse relaxation rate or FA alone | Multimodal imaging using a combination of transverse relaxation rate and FA values in the SN | AUC = 0.99 |
| Transverse relaxation rate in the SN | AUC = 0.93 | |||
| FA in the SN | AUC = 0.74 | |||
| Long et al. (2012) | PD 19/HC 27 | The combination of multimodal imaging and multi-level measurements provided good diagnostic accuracy ↓ Regional homogeneity value in the bilateral middle frontal gyrus, orbital part, ↓ amplitude of low-frequency fluctuations decreases in the left rolandic operculum in PD vs. HC ↑ Regional functional connectivity strength in the left parahippocampal gyrus, left angular gyrus and right middle temporal gyrus in PD vs. HC ↓ GM volume in the left paracentral lobule in PD vs. HC ↑ GM volume of the left precentral gyrus and the bilateral posterior cingulate gyrus in PD vs. HC Brain regions showing WM volume changes were mainly located in the frontal and temporal lobes |
Automated method combining resting state fMRI and structural images | Se 79 Sp 93 |
| Diffusion imaging | ||||
| Prodoehl et al. (2013) | PD 15/MSA 14-P/PSP 12/ ET 14/HC 17 |
Multi-target imaging approach focused on the basal ganglia and cerebellum accurately classifies control subjects and patients with PD, MSA-P, PSP, and ET | Model using DTI measures from the caudate nucleus and SN, and dentate nucleus | Se 92 (PD) Sp 87 (ET) AUC = 0.96 |
| Model using DTI measures from the SN and MCP | Se 94 (PD) Sp 100 (PD vs. MSA) AUC = 0.99 |
|||
| Model using DTI measures from the putamen and SN | Se 87 (PD) Sp 100 (PD vs. PSP) AUC = 0.96 |
|||
| Model using DTI measures from the putamen, SN, and dentate nucleus | Se 90 (PD) Sp 100 (PD vs. MSA, PSP) AUC = 0.99 |
|||
| Hirata et al. (2016) | Meta-analysis including 806 PD patients and 626 controls from 22 studies | ↓ Nigral FA in PD | Decreased nigral FA | Se 72 Sp 63 |
| Neuromelanin-sensitive MRI | ||||
| Castellanos et al. (2015) | PD 36 (23 idiopathic and 13 monogenic PARKIN or LRRK2 mutations)/HC 37 | ↓ Signal intensity in the locus coeruleus and SNc in neuromelanin-sensitive imaging in PD vs. HC | SNc volume measurements | Se 92 (PD) Sp 89 (vs. HC) AUC = 0.92 |
| Resting state fMRI | ||||
| Szewczyk-Krolikowski et al. (2014) | PD 19/HC 19 in the discovery cohort PD 13 (including 5 drug naïve) in the validation cohort | Reduced functional connectivity within BGN in PD | Average BGN connectivity | Se 100 (PD-discovery cohort), 85 (PD-validation cohort) Sp 89 |
| Chen et al. (2015) | PD 21/HC 26 | The majority of the most discriminative functional connections were located within or across the default mode, cingulo-opercular and frontal-parietal networks and the cerebellum. | Whole-brain functional connectivity | Accuracy 94 |
| Wu et al. (2015) | PD 58/HC 54 (PD 28/HC 28 in the derivation sample and PD 30/HC 26 in the validation sample) | The topographic pattern of neural activity in PD was characterized by decreased activity in the striatum, supplementary motor area, middle frontal gyrus, and occipital cortex, and increased activity in the thalamus, cerebellum, precuneus, superior parietal lobule, and temporal cortex | PD-related spatial covariance pattern-amplitude of low-frequency fluctuation | Whole cohort: Se 91 (PD) Sp 89 (HC) AUC = 0.97 Derivation sample: Se 82 Sp 79 AUC = 0.92 Validation sample: Se70 Sp 69 AUC = 0.78 |
T tesla, MRI magnetic resonance imaging, Se sensitivity, Sp specificity, AUC area under the curve, ↑ significant higher, ↓ significant lower, PD Parkinson’s disease, HC healthy controls, ET essential tremor, MSA-P parkinsonian variant of MSA, PSP progressive supranuclear palsy, R2* relaxation rates = 1/T2*, BGN basal ganglia network, SN substantia nigra, SNc SN pars compacta, DNH dorsolateral nigral hyperintensity, GM grey matter, WM white matter, DWI diffusion-weighted imaging, DTI diffusion tensor imaging, FA fractional anisotropy, VCDR voxels for all connectivity-defined subregions, MCP middle cerebellar peduncle, fMRI functional MRI