RESEARCH: Differentiating multiple system atrophy from Parkinson's disease

[Guest guest]

J Neurol Neurosurg Psychiatry 2002 Nov;73(5):517-23

Differentiating multiple system atrophy from Parkinson's disease:

contribution

of striatal and midbrain MRI volumetry and multi-tracer PET imaging.

Ghaemi M, Hilker R, Rudolf J, Sobesky J, Heiss WD.

Neurology Department, University Hospital, Cologne, Germany

Max-Planck-Institute

for Neurological Research, Cologne, Germany.

OBJECTIVES: The differential diagnosis between typical idiopathic

Parkinson's

disease (PD) and the striatonigral variant of multiple system atrophy

(MSA-P) is

often difficult because of the presence of signs and symptoms common to both

forms of parkinsonism, particularly at symptom onset. This study

investigated

striatal and midbrain findings in MSA-P and PD patients in comparison with

normal controls with the use of positron emission tomography (PET) and three

dimensional magnetic resonance imaging (3D MRI) based volumetry to increase

the

differential diagnostic accuracy between both disease entities. METHODS:

Nine

patients with MSA-P, 24 patients with PD, and seven healthy controls were

studied by MRI and PET with 6-[(18)F]-fluoro-L-dopa (FDOPA),

[(18)F]fluoro-deoxyglucose (FDG), and 11-C-Raclopride (RACLO). Striatal and

extrastriatal volumes of interest (VOI) were calculated on the basis of the

individual MRI data. The PET data were transferred to the VOI datasets and

subsequently analysed. RESULTS: MSA-P differed significantly from PD

patients in

terms of decreased putaminal volume, glucose metabolism, and postsynaptic D2

receptor density. The striatal FDOPA uptake was equally impaired in both

conditions. Neither MRI volumetry nor PET imaging of the midbrain region

further

contributed to the differential diagnosis between PD and MSA-P. CONCLUSIONS:

The

extent and spatial distribution of functional and morphological changes in

the

striatum permit the differentiation of MSA-P from PD. Both, multi-tracer PET

and

3D MRI based volumetry, may be considered equivalent in the assessment of

different striatal abnormality in both disease entities. In contrast, MRI

and

PET imaging of the midbrain does not provide a further gain in diagnostic

accuracy.

PMID: 12397143 [PubMed - in process]

[Guest guest]

J Neurol Neurosurg Psychiatry 2002 Nov;73(5):517-23

Differentiating multiple system atrophy from Parkinson's disease:

contribution

of striatal and midbrain MRI volumetry and multi-tracer PET imaging.

Ghaemi M, Hilker R, Rudolf J, Sobesky J, Heiss WD.

Neurology Department, University Hospital, Cologne, Germany

Max-Planck-Institute

for Neurological Research, Cologne, Germany.

OBJECTIVES: The differential diagnosis between typical idiopathic

Parkinson's

disease (PD) and the striatonigral variant of multiple system atrophy

(MSA-P) is

often difficult because of the presence of signs and symptoms common to both

forms of parkinsonism, particularly at symptom onset. This study

investigated

striatal and midbrain findings in MSA-P and PD patients in comparison with

normal controls with the use of positron emission tomography (PET) and three

dimensional magnetic resonance imaging (3D MRI) based volumetry to increase

the

differential diagnostic accuracy between both disease entities. METHODS:

Nine

patients with MSA-P, 24 patients with PD, and seven healthy controls were

studied by MRI and PET with 6-[(18)F]-fluoro-L-dopa (FDOPA),

[(18)F]fluoro-deoxyglucose (FDG), and 11-C-Raclopride (RACLO). Striatal and

extrastriatal volumes of interest (VOI) were calculated on the basis of the

individual MRI data. The PET data were transferred to the VOI datasets and

subsequently analysed. RESULTS: MSA-P differed significantly from PD

patients in

terms of decreased putaminal volume, glucose metabolism, and postsynaptic D2

receptor density. The striatal FDOPA uptake was equally impaired in both

conditions. Neither MRI volumetry nor PET imaging of the midbrain region

further

contributed to the differential diagnosis between PD and MSA-P. CONCLUSIONS:

The

extent and spatial distribution of functional and morphological changes in

the

striatum permit the differentiation of MSA-P from PD. Both, multi-tracer PET

and

3D MRI based volumetry, may be considered equivalent in the assessment of

different striatal abnormality in both disease entities. In contrast, MRI

and

PET imaging of the midbrain does not provide a further gain in diagnostic

accuracy.

PMID: 12397143 [PubMed - in process]