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Arterial spin labeling detects perfusion patterns related to motor symptoms in Parkinson's disease
Swati Rane1, Natalie Koh1, John Oakley2
1Integrated Brain Imaging Center, Radiology, University of Washington Medical Center, Seattle, WA, USA.
Introduction:
Imaging neurovascular disturbances in Parkinson's disease (PD) is an excellent measure of disease severity. Indeed, a disease-specific regional pattern of abnormal metabolism has been identified using positron emission tomography. Only a handful of studies, however, have applied perfusion MRI to detect this disease pattern. Our goal was to replicate the evaluation of a PD-related perfusion pattern using scaled subprofile modeling/principal component analysis (SSM-PCA).
Methods:
We applied arterial spin labeling (ASL) MRI for this purpose. Uniquely, we assessed this pattern separately in PD individuals ON and OFF dopamine medications. We further compared the existence of these patterns and their strength in each individual with their Movement Disorder Society-Unified Parkinson's Disease Rating Scale motor (MDS-UPDRS) scores, cholinergic tone as indexed by short-term afferent inhibition (SAI), and other neuropsychiatric tests.
Results:
We observed a PD-related perfusion pattern that was similar to previous studies. The patterns were observed in both ON and OFF states but only the pattern in the OFF condition could significantly (AUC=0.72) differentiate between PD and healthy subjects. In the ON condition, PD subjects were similar to controls from a CBF standpoint (AUC=0.45). The OFF pattern prominently included the posterior cingulate, precentral region, precuneus, and the subcallosal cortex. Individual principal components from the ON and OFF states were strongly associated with MDS-UPDRS scores, SAI amplitude and latency.
Conclusion:
Using ASL, our study identified patterns of abnormal perfusion in PD and were associated with disease symptoms.
Insights
Arterial spin labeling MRI identified Parkinson's disease (PD) perfusion patterns. These patterns, particularly when patients were OFF medication, correlated with disease severity and symptoms.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Neuroimaging, specifically positron emission tomography, has identified abnormal metabolism patterns in Parkinson's disease (PD).
- Perfusion MRI has been less explored for detecting PD-related patterns, despite its potential for assessing disease severity.
Purpose of the Study:
- To replicate the evaluation of a Parkinson's disease-related perfusion pattern using scaled subprofile modeling/principal component analysis (SSM-PCA).
- To assess perfusion patterns in PD patients both ON and OFF dopamine medication using arterial spin labeling (ASL) MRI.
- To correlate identified perfusion patterns with clinical measures like MDS-UPDRS scores and cholinergic tone.
Main Methods:
- Arterial spin labeling (ASL) MRI was employed to assess cerebral blood flow (CBF) patterns.
- Scaled subprofile modeling/principal component analysis (SSM-PCA) was used to identify and analyze perfusion patterns.
- PD patients were assessed ON and OFF dopamine medication, and results were compared to healthy controls and correlated with clinical assessments.
Main Results:
- A PD-related perfusion pattern was identified, consistent with previous studies.
- The pattern was present in both ON and OFF medication states, but only the OFF state pattern significantly differentiated PD patients from controls (AUC=0.72).
- Perfusion patterns in both states correlated significantly with Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) motor scores and short-term afferent inhibition (SAI).
Conclusions:
- ASL MRI successfully identified abnormal perfusion patterns in Parkinson's disease.
- These perfusion patterns are associated with disease severity and symptoms, particularly when patients are not taking medication.
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