Distinct progression pattern of susceptibility MRI in the substantia nigra of Parkinson's patients

Journal Article · Mon May 14 00:00:00 EDT 2018 · Movement Disorders

DOI:https://doi.org/10.1002/mds.27318· OSTI ID:1437062

Du, Guangwei ^[1]; Lewis, Mechelle M. ^[2]; Sica, Christopher ^[3]; He, Lu ^[4]; Connor, James R. ^[5]; Kong, Lan ^[6]; Mailman, Richard B. ^[2]; Huang, Xuemei ^[7]

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1. Department of Neurology Penn State University‐Milton S. Hershey Medical Center Hershey Pennsylvania United States
2. Department of Neurology Penn State University‐Milton S. Hershey Medical Center Hershey Pennsylvania United States, Department of Pharmacology Penn State University‐Milton S. Hershey Medical Center Hershey Pennsylvania United States
3. Department of Radiology Penn State University‐Milton S. Hershey Medical Center Hershey Pennsylvania United States
4. School of Public Health Shanxi Medical University Taiyuan Shanxi China
5. Department of Neurosurgery Penn State University‐Milton S. Hershey Medical Center Hershey Pennsylvania United States
6. Department of Public Health Sciences Penn State University‐Milton S. Hershey Medical Center Hershey Pennsylvania United States
7. Department of Neurology Penn State University‐Milton S. Hershey Medical Center Hershey Pennsylvania United States; Department of Pharmacology Penn State University‐Milton S. Hershey Medical Center Hershey Pennsylvania United States; Department of Radiology Penn State University‐Milton S. Hershey Medical Center Hershey Pennsylvania United States; Department of Neurosurgery Penn State University‐Milton S. Hershey Medical Center Hershey Pennsylvania United States; Department of Kinesiology Penn State University‐Milton S. Hershey Medical Center Hershey Pennsylvania United States

Abstract

Background: Susceptibility MRI may capture Parkinson's disease‐related pathology. This study delineated longitudinal changes in different substantia nigra regions.

Methods: Seventy‐two PD patients and 62 controls were studied at both baseline and after 18 months with MRI. R2* and quantitative susceptibility mapping values from the substantia nigra pars compacta and substantia nigra pars reticulata were calculated. Mixed‐effects models compared controls with PD or PD subgroups having different disease durations: early (<1 year), middle (<5 years, middle‐stage PD), and late (>5 years, late‐stage PD). Pearson's correlation assessed associations between imaging and clinical measures.

Results: At baseline, R2* and quantitative susceptibility mapping were higher in both the substantia nigra pars compacta and substantia nigra pars reticulata in all PD patients (group effect, P  ≤ 0.003). Longitudinally, the substantia nigra pars compacta R2* showed a faster increase in PD compared with controls (time × group, P  = 0.002), whereas quantitative susceptibility mapping did not ( P  = 0.668). The substantia nigra pars reticulata R2* and quantitative susceptibility mapping did not differ between PD and controls (time × group, P  ≥ 0.084), although both decreased longitudinally (time effect, P  ≤ 0.004). Baseline substantia nigra pars compacta R2* was higher in all PD subgroups (group, P  ≤ 0.006), but showed a significantly faster increase only in later‐stage PD (time × group, P  < 0.0001) that correlated with changes in nonmotor symptoms ( r  = 0.746, P  = 0.002). Baseline substantia nigra pars reticulata quantitative susceptibility mapping was higher in middle‐stage PD and later‐stage PD (group, P  ≤ 0.002), but showed a longitudinal decrease (time × group, P  = 0.004) only in later‐stage PD that correlated with changes in motor signs ( r  = 0.837, P  < 0.001).

Conclusion: Susceptibility MRI revealed distinct patterns of PD progression in the substantia nigra pars compacta and substantia nigra pars reticulata. The different patterns are particularly clear in later‐stage patients. These findings may resolve past controversies and have implications in the pathophysiological processes during PD progression. © 2018 International Parkinson and Movement Disorder Society

• Sponsoring Organization: USDOE
• OSTI ID: 1437062
• Journal Information: Movement Disorders, Journal Name: Movement Disorders Journal Issue: 9 Vol. 33; ISSN 0885-3185
• Publisher: Wiley Blackwell (John Wiley & Sons)
• Country of Publication: Country unknown/Code not available
• Language: English