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Updated: Jul 16, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Usefulness of combined fractional anisotropy and apparent diffusion coefficient values for detection of involvement
Mizuki Ito1, Hirohisa Watanabe, Yoshinari Kawai
1Department of Neurology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho Showa-ku, Nagoya 466-8550, Japan.
Objective:
To determine whether apparent diffusion coefficient (ADC) values and fractional anisotropy (FA) values can detect early pathological involvement in multiple system atrophy (MSA), and be used to differentiate MSA-P (multiple system atrophy if parkinsonian features predominate) from Parkinson's disease (PD).
Methods:
We compared ADC and FA values in the pons, cerebellum and putamen of 61 subjects (20 probable MSA patients, 21 age matched PD patients and 20 age matched healthy controls) using a 3.0 T magnetic resonance system.
Results:
ADC values in the pons, cerebellum and putamen were significantly higher, and FA values lower in MSA than in PD or controls. These differences were prominent in MSA lacking dorsolateral putaminal hyperintensity (DPH) or hot cross bun (HCB) sign. In differentiating MSA-P from PD using FA and ADC values, we obtained equal sensitivity (70%) and higher specificity (100%) in the pons than in the putamen and cerebellum. In addition, all patients that had both significant low FA and high ADC values in each of these three areas were MSA-P cases, and those that had both normal FA and ADC values in the pons were all PD cases. Our diagnostic algorithm based on these results accurately diagnosed 90% of patients with MSA-P.
Conclusion:
FA and ADC values detected early pathological involvement prior to magnetic resonance signal changes in MSA. In particular, low FA values in the pons showed high specificity in discriminating MSA-P from PD. In addition, combined analysis of both FA and ADC values in all three areas was more useful than only one.
Insights
Diffusion tensor imaging metrics, apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values, can detect early multiple system atrophy (MSA) pathology. These values effectively differentiate MSA-P from Parkinson
Area of Science:
- Neuroimaging
- Diffusion Tensor Imaging
- Neurology
Background:
- Multiple System Atrophy (MSA) is a neurodegenerative disorder.
- Distinguishing MSA-P (parkinsonian subtype) from Parkinson's Disease (PD) is clinically challenging.
- Early pathological changes in MSA may precede detectable signal alterations on conventional MRI.
Purpose of the Study:
- To evaluate the utility of apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values in detecting early pathological involvement in MSA.
- To assess the efficacy of ADC and FA values in differentiating MSA-P from PD.
Main Methods:
- Comparison of ADC and FA values in the pons, cerebellum, and putamen.
- Study included 61 subjects: 20 probable MSA patients, 21 PD patients, and 20 healthy controls.
- Data acquired using a 3.0 T magnetic resonance system.
Main Results:
- MSA patients exhibited significantly higher ADC and lower FA values in the pons, cerebellum, and putamen compared to PD patients and controls.
- These differences were more pronounced in MSA cases lacking the dorsolateral putaminal hyperintensity (DPH) or hot cross bun (HCB) sign.
- A diagnostic algorithm utilizing combined FA and ADC values achieved 90% accuracy in diagnosing MSA-P, with high specificity (100%) in the pons for differentiating MSA-P from PD.
Conclusions:
- ADC and FA values can identify early pathological changes in MSA, even before conventional MRI signal changes are apparent.
- Low FA values in the pons demonstrate high specificity for discriminating MSA-P from PD.
- Combined analysis of FA and ADC values across multiple brain regions offers superior diagnostic utility compared to single-parameter analysis.
