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. 2014 Nov 18;9(11):e112638.
doi: 10.1371/journal.pone.0112638. eCollection 2014.

Diffusion tensor imaging of Parkinson's disease, multiple system atrophy and progressive supranuclear palsy: a tract-based spatial statistics study

Amanda Worker  1 , Camilla Blain  2 , Jozef Jarosz  3 , K Ray Chaudhuri  4 , Gareth J Barker  5 , Steve C R Williams  6 , Richard G Brown  1 , P Nigel Leigh  7 , Flavio Dell'Acqua  1 , Andrew Simmons  1
Affiliations

Diffusion tensor imaging of Parkinson's disease, multiple system atrophy and progressive supranuclear palsy: a tract-based spatial statistics study

Amanda Worker et al. PLoS One. .

Abstract

Although often clinically indistinguishable in the early stages, Parkinson's disease (PD), Multiple System Atrophy (MSA) and Progressive Supranuclear Palsy (PSP) have distinct neuropathological changes. The aim of the current study was to identify white matter tract neurodegeneration characteristic of each of the three syndromes. Tract-based spatial statistics (TBSS) was used to perform a whole-brain automated analysis of diffusion tensor imaging (DTI) data to compare differences in fractional anisotropy (FA) and mean diffusivity (MD) between the three clinical groups and healthy control subjects. Further analyses were conducted to assess the relationship between these putative indices of white matter microstructure and clinical measures of disease severity and symptoms. In PSP, relative to controls, changes in DTI indices consistent with white matter tract degeneration were identified in the corpus callosum, corona radiata, corticospinal tract, superior longitudinal fasciculus, anterior thalamic radiation, superior cerebellar peduncle, medial lemniscus, retrolenticular and anterior limb of the internal capsule, cerebral peduncle and external capsule bilaterally, as well as the left posterior limb of the internal capsule and the right posterior thalamic radiation. MSA patients also displayed differences in the body of the corpus callosum corticospinal tract, cerebellar peduncle, medial lemniscus, anterior and superior corona radiata, posterior limb of the internal capsule external capsule and cerebral peduncle bilaterally, as well as the left anterior limb of the internal capsule and the left anterior thalamic radiation. No significant white matter abnormalities were observed in the PD group. Across groups, MD correlated positively with disease severity in all major white matter tracts. These results show widespread changes in white matter tracts in both PSP and MSA patients, even at a mid-point in the disease process, which are not found in patients with PD.

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Conflict of interest statement

Competing Interests: GJB has received honoraria for teaching for General Electric Healthcare, and acts as a consultant for IXICO. This does not alter the authors’ adherence to PLOS ONE policies on sharing data and materials.

Figures

Figure 1
Figure 1. White matter maps showing regions of significant decreased fractional anisotropy and increased mean diffusivity in PSP patients when compared to healthy controls, PD and MSA (Bonferroni corrected alpha = 0.0167).
Background image corresponds to the mean fractional anisotropy image of all subjects in standard MNI152 space (radiological view). Fractional anisotropy white matter skeleton is represented by green voxels. Blue voxels represent regions of decreased FA and yellow voxels represent regions of increased MD in the PSP group.
Figure 2
Figure 2. White matter maps showing regions of significant decreased fractional anisotropy and increased mean diffusivity in MSA patients when compared to healthy controls and PD (Bonferroni corrected alpha = 0.0167).
Background image corresponds to the mean fractional anisotropy image of all subjects in standard MNI152 space (radiological view). Fractional anisotropy white matter skeleton is represented by green voxels. Blue voxels represent regions of decreased FA and yellow voxels represent regions of increased MD in the PSP group.
Figure 3
Figure 3. White matter maps showing regions of significant correlation between mean diffusivity and measures of disease severity (Bonferroni corrected alpha = 0.0167).
Top row coronal view, bottom row axial view. Background image corresponds to the mean fractional anisotropy image of all subjects in standard MNI152 space (radiological view). Fractional anisotropy white matter skeleton is represented by green voxels. Blue voxels represent regions of decreased FA and yellow voxels represent regions of increased MD in the PSP group.
See this image and copyright information in PMC

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Publication types

Grants and funding

Support for this study was provided by the NIHR Biomedical Research Centre for Mental Health and NIHR Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, King’s College London. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.