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Differentiation among parkinsonisms using quantitative diffusion kurtosis imaging.

Kenji Ito¹, Makoto Sasaki, Chigumi Ohtsuka

¹aDivision of Ultra-high Field MRI, Institute for Biomedical Sciences bDepartment of Neurology and Gerontology, Iwate Medical University, Iwate cCentral Research Laboratory, Hitachi Ltd, Tokyo, Japan.

|February 26, 2015

Summary

Diffusion kurtosis imaging (DKI) can differentiate parkinsonism types. The midbrain tegmentum/pontine crossing tract (MBT/PCT) ratio from mean kurtosis (MK) maps effectively distinguishes multiple system atrophy and progressive supranuclear palsy syndrome.

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Area of Science:

Neuroimaging
Radiology
Neurology

Background:

Distinguishing between Parkinson's disease (PD), multiple system atrophy (MSA), and progressive supranuclear palsy syndrome (PSPS) presents diagnostic challenges.
Pathological changes in these neurodegenerative disorders can overlap, complicating clinical differentiation.
Advanced imaging techniques are needed to identify objective biomarkers for accurate diagnosis.

Purpose of the Study:

To evaluate the utility of diffusion kurtosis imaging (DKI) in detecting pathological changes.
To determine if DKI can differentiate between patients with PD, MSA, and PSPS.
To assess the diagnostic value of specific DKI-derived metrics, such as mean kurtosis (MK) and mean diffusivity (MD) ratios.

Main Methods:

Fourteen patients (five PD, four MSA, five PSPS) and six healthy controls underwent 1.5-T MRI.
Diffusion kurtosis imaging (DKI) was performed to generate MK, fractional anisotropy, and MD maps.
Quantitative analysis of midbrain tegmentum (MBT) and pontine crossing tract (PCT) values and their ratios (MBT/PCT) was conducted.

Main Results:

No significant differences in MBT and PCT values were found among the groups using DKI.
MBT/PCT ratios derived from MK maps showed significant increases in MSA and decreases in PSPS compared to controls and PD.
MBT/PCT ratios from MD maps revealed significant increases in the PSPS group.

Conclusions:

Quantitative DKI analysis, particularly the MBT/PCT ratio from MK maps, shows promise in differentiating between parkinsonism subtypes.
DKI offers a potential non-invasive method to aid in the differential diagnosis of neurodegenerative parkinsonian syndromes.
The MBT/PCT ratio derived from MK maps may serve as a valuable imaging biomarker for distinguishing MSA and PSPS.