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The difference in putamen volume between MSA and PD: evidence from a meta-analysis
Wataru Sako1, Nagahisa Murakami2, Yuishin Izumi2
1Department of Clinical Neuroscience, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan; Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, NY, USA.
Background:
The accurate and non-invasive tool for differential diagnosis between multiple system atrophy (MSA) and Parkinson's disease (PD) is needed at the early stage of disease for clinical trials of disease modifying therapy. PET is helpful, but the availability is limited. MRI is considered to be more available and potential method instead of PET. We aimed to investigate the effect of MSA and PD on putamen volume using a meta-analysis approach.
Methods:
A computer literature search yielded 6 eligible studies. Putamen volume was expressed as the standardized mean difference between MSA and PD patients. Moreover, subgroup analyses planed to be performed in order to identify factors which contributed to heterogeneity if included studies were not homogeneous. The proportion of variation due to heterogeneity was computed and expressed as I(2).
Results:
Six studies, comprising a sample size of 84 MSA and 180 PD, were included in this meta-analysis. The overall effect indicated that putamen volume in MSA was significantly more reduced than that in PD with heterogeneous studies (P = 0.0004, 6 studies, n = 264, I(2) = 87%). A subgroup analysis revealed that the category of "Hoehn-Yahr stage of PD" showed a significant subgroup difference with a significant subgroup summary effect (subgroup difference: P = 0.003).
Conclusions:
Our findings based on group-level analysis suggested that volumetry of the putamen could be useful for differential diagnosis between MSA and PD at the early stage of disease, and also help to enroll more accurate disease group for disease modifying study in future.
Insights
Putamen volume is significantly reduced in multiple system atrophy (MSA) compared to Parkinson's disease (PD). This MRI-based finding aids early differential diagnosis for clinical trials.
Area of Science:
- Neuroimaging
- Neurodegenerative Diseases
- Clinical Diagnostics
Background:
- Accurate, non-invasive tools are crucial for early differential diagnosis between multiple system atrophy (MSA) and Parkinson's disease (PD).
- Magnetic Resonance Imaging (MRI) offers a more accessible alternative to Positron Emission Tomography (PET) for diagnostic purposes.
- Investigating putamen volume changes can aid in distinguishing these conditions.
Purpose of the Study:
- To meta-analyze the effect of MSA and PD on putamen volume.
- To evaluate the potential of putamen volumetry as a diagnostic tool.
- To inform patient selection for disease-modifying therapy clinical trials.
Main Methods:
- A meta-analysis was conducted on 6 eligible studies.
- Putamen volume differences between MSA and PD patients were expressed as standardized mean differences.
- Subgroup analyses were performed to explore heterogeneity, including factors like Hoehn-Yahr stage.
Main Results:
- Putamen volume was significantly more reduced in MSA patients compared to PD patients (P = 0.0004).
- The meta-analysis included 84 MSA and 180 PD patients across 6 studies, revealing significant heterogeneity (I(2) = 87%).
- Subgroup analysis indicated that the Hoehn-Yahr stage of PD significantly influenced the results (P = 0.003).
Conclusions:
- Putamen volumetry, assessed via MRI, shows promise for differentiating early-stage MSA from PD.
- This imaging biomarker can facilitate more accurate patient stratification in clinical trials for neurodegenerative diseases.
- The findings support the use of putamen volume as a diagnostic aid and for optimizing clinical trial enrollment.
