Parkinson's disease or multiple system atrophy: potential separation by quantitative susceptibility mapping

Marxreiter F, Lambrecht V, Mennecke A, Hanspach J, Jukic J, Regensburger M, Herrler J, German A, Kassubek J, Groen G, Mueller HP, Laun FB, Dörfler A, Winkler J, Schmidt M (2023)

Publication Type: Journal article

Publication year: 2023

Journal

Therapeutic Advances in Neurological Disorders SAGE Publications

Book Volume: 16

DOI: 10.1177/17562864221143834

Abstract

Background:Due to the absence of robust biomarkers, and the low sensitivity and specificity of routine imaging techniques, the differential diagnosis between Parkinson's disease (PD) and multiple system atrophy (MSA) is challenging. High-field magnetic resonance imaging (MRI) opened up new possibilities regarding the analysis of pathological alterations associated with neurodegenerative processes. Recently, we have shown that quantitative susceptibility mapping (QSM) enables visualization and quantification of two major histopathologic hallmarks observed in MSA: reduced myelin density and iron accumulation in the basal ganglia of a transgenic murine model of MSA. It is therefore emerging as a promising imaging modality on the differential diagnosis of Parkinsonian syndromes. Objectives:To assess QSM on high-field MRI for the differential diagnosis of PD and MSA. Methods:We assessed 23 patients (nine PDs and 14 MSAs) and nine controls using QSM on 3T and 7T MRI scanners at two academic centers. Results:We observed increased susceptibility in MSA at 3T in prototypical subcortical and brainstem regions. Susceptibility measures of putamen, pallidum, and substantia nigra reached excellent diagnostic accuracy to separate both synucleinopathies. Increase toward 100% sensitivity and specificity was achieved using 7T MRI in a subset of patients. Magnetic susceptibility correlated with age in all groups, but not with disease duration in MSA. Sensitivity and specificity were particularly high for possible MSA, and reached 100% in the putamen. Conclusion:Putaminal susceptibility measures, in particular on ultra-high-field MRI, may distinguish MSA patients from both, PD and controls, allowing an early and sensitive diagnosis of MSA.

Authors with CRIS profile

Franz Marxreiter Department of Molecular Neurology Vera Lambrecht Department of Neurology Angelika Mennecke Neuroradiologisches Institut Jannis Hanspach Professur für quantitative MR-Bildgebung (Heisenberg-Professur) Jelena Jukic Department of Molecular Neurology Martin Regensburger Professur für Stammzell-Modelle seltener neuraler Erkrankungen Jürgen Herrler Department of Neuroradiology Alexander German Professur für quantitative MR-Bildgebung (Heisenberg-Professur) Frederik Bernd Laun Professur für quantitative MR-Bildgebung (Heisenberg-Professur) Arnd Dörfler Jürgen Winkler Professur für Molekulare Neurologie Manuel Schmidt Neuroradiologisches Institut

Involved external institutions

Universität Ulm DE Germany (DE)

How to cite

APA:

Marxreiter, F., Lambrecht, V., Mennecke, A., Hanspach, J., Jukic, J., Regensburger, M.,... Schmidt, M. (2023). Parkinson's disease or multiple system atrophy: potential separation by quantitative susceptibility mapping. Therapeutic Advances in Neurological Disorders, 16. https://doi.org/10.1177/17562864221143834

MLA:

Marxreiter, Franz, et al. "Parkinson's disease or multiple system atrophy: potential separation by quantitative susceptibility mapping." Therapeutic Advances in Neurological Disorders 16 (2023).

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