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Brain Morphology of Cannabis Users With or Without Psychosis: A Pilot MRI Study

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Individual voxel-based morphometry adjusting covariates in multiple system atrophy.

Junya Ebina¹, Kazuhiro Hara², Hirohisa Watanabe³

¹Brain and Mind Research Center, Nagoya University, Aichi, Japan; Division of Neurology, Department of Internal Medicine, Toho University Graduate School of Medicine, Tokyo, Japan.

Parkinsonism & Related Disorders

|September 4, 2021

Summary

Novel individual voxel-based morphometry adjusting covariates (iVAC) accurately detects multiple system atrophy (MSA) brain changes. This method significantly improves diagnostic accuracy for differentiating MSA from Parkinson

Keywords:

Differential diagnosis Individual voxel-based morphometry adjusting covariates Magnetic resonance imaging Multiple system atrophy Parkinson's disease

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Area of Science:

Neuroimaging
Neurology
Radiology

Background:

Multiple System Atrophy (MSA) and Parkinson's Disease (PD) are neurodegenerative disorders with overlapping symptoms.
Accurate differentiation between MSA and PD is crucial for appropriate patient management and treatment.
Current diagnostic methods may not always achieve sufficient accuracy, necessitating improved imaging techniques.

Purpose of the Study:

To evaluate the diagnostic accuracy of individual voxel-based morphometry adjusting covariates (iVAC) for Multiple System Atrophy (MSA).
To determine if iVAC can effectively differentiate MSA from Parkinson's Disease (PD).
To compare the sensitivity of iVAC with traditional T2-weighted imaging (T2-WI) in detecting atrophic changes.

Main Methods:

A cohort of 53 MSA patients (including MSA-C and MSA-P subtypes), 53 PD patients, and 189 healthy controls were recruited.
All participants underwent high-resolution T1-weighted and T2-weighted MRI scans on a 3.0-T scanner.
iVAC analysis was performed, adjusting for covariates like age, sex, and total intracranial volume, to detect atrophic changes in the pons/middle cerebellar peduncle (MCP) and putamen.

Main Results:

iVAC identified abnormal findings in the pons/MCP in 96.2% of MSA patients and the putamen in 80% of MSA patients, significantly higher than T2-WI (60.4% for both).
iVAC detected significant atrophic changes in the pons/MCP or putamen in 98.1% of MSA-P patients, compared to 69.8% with T2-WI.
iVAC demonstrated high diagnostic performance, achieving 95.0% sensitivity and 96.2% specificity for differentiating MSA-P from PD.

Conclusions:

iVAC provides a visually recognizable and highly accurate method for assessing morphological characteristics in MSA.
iVAC significantly outperforms T2-WI in detecting characteristic atrophic changes associated with MSA.
iVAC is a promising tool for the accurate diagnosis and screening of MSA, aiding in its differentiation from PD.