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Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
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Advanced Cognitive Patterns in Multiple System Atrophy Compared to Parkinson's Disease: An Individual Diffusion

Huize Pang1, Ziyang Yu1, Hongmei Yu2

  • 1Department of Radiology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China (H.P., Z.Y., X.L., S.B., Y.L., J.W., M.Z., G.F.).

Academic Radiology
|January 14, 2024
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Summary

Multiple system atrophy with mild cognitive impairment (MSA-MCI) shows greater white matter degeneration than Parkinson's disease with mild cognitive impairment (PD-MCI). Diffusion MRI metrics effectively predict cognitive impairment in these alpha-synucleinopathies.

Keywords:
Diffusion tensor imagingMild cognitive impairmentMultiple system atrophyParkinson’s disease

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Area of Science:

  • Neuroscience
  • Radiology
  • Neurology

Background:

  • Multiple system atrophy (MSA) and Parkinson's disease (PD) are alpha-synucleinopathies with differing prognoses.
  • White matter degeneration significantly impacts cognitive function in neurodegenerative diseases.
  • The specific effects of PD and MSA on white matter functioning and cognition remain unclear.

Purpose of the Study:

  • To investigate and compare white matter integrity in patients with MSA and mild cognitive impairment (MSA-MCI) versus Parkinson's disease and mild cognitive impairment (PD-MCI).
  • To identify white matter microstructural differences and their association with cognitive performance in MSA-MCI and PD-MCI.
  • To determine the predictive value of diffusion tensor imaging (DTI) metrics for cognitive impairment in these conditions.

Main Methods:

  • Diffusion tensor imaging (DTI) and cognitive assessments were performed on 116 participants (37 MSA-MCI, 37 PD-MCI, 42 controls).
  • Probabilistic fiber tracking was used to reconstruct association, projection, and thalamic fibers.
  • Regression, support vector machine, and SHAP analyses evaluated the link between diffusion metrics and cognitive domains.

Main Results:

  • MSA-MCI patients exhibited more pronounced white matter damage, including in the middle cerebellar peduncle, corticospinal tract, and cingulum bundle.
  • Fractional anisotropy (FA) and mean diffusivity (MD) of the anterior thalamic radiation correlated significantly with global efficiency.
  • Diffusion metrics differentiated between PD-MCI and MSA-MCI, predicting cognitive impairment with 73% accuracy, with anterior thalamic radiation MD being the strongest predictor.

Conclusions:

  • MSA-MCI is associated with more significant white matter deterioration compared to PD-MCI, impacting various cognitive domains.
  • Diffusion MRI is a valuable tool for understanding the neurological underpinnings of cognitive deficits in Parkinsonian disorders.
  • Identifying specific white matter alterations can aid in differentiating and managing cognitive impairment in MSA and PD.