MRI volumetric morphometry in vascular parkinsonism

Area of Science:

• Neurology
• Radiology
• Neuroimaging

Background:

• Vascular parkinsonism (VP) presents diagnostic challenges in elderly individuals.
• Distinguishing VP from Parkinson's disease (PD) is crucial for appropriate management.

Purpose of the Study:

• To identify brain morphometric MRI markers differentiating VP from PD and healthy controls in the elderly.
• To assess the diagnostic value of caudate nucleus and white matter hyperintense lesion (WMHL) volumes.

Main Methods:

• Multicenter prospective study involving 46 parkinsonism patients (32 PD, 14 VP) and 29 controls (mean age ~78 years).
• Brain MRI (3-T scanner, T1 MPRAGE, FLAIR) and volumetric morphometry using Morphobox software.
• Receiver operating characteristics (ROC) curve analysis to evaluate diagnostic performance.

Main Results:

• Patients with VP showed significantly higher caudate nucleus and WMHL volumes compared to PD and controls.
• Normalized caudate volume (≥0.67%) and WMHL volume (≥1.11%) effectively identified VP.
• Positive correlation (ρ=0.74) between caudate nucleus and WMHL volumes suggests vascular remodeling.

Conclusions:

• Caudate nucleus and WMHL MRI volumes serve as potential additional markers for identifying VP in elderly patients.
• These MRI findings can aid in the initial workup of parkinsonian symptoms in older adults.