Structural changes in Parkinson's disease: voxel-based morphometry and diffusion tensor imaging analyses based on 123I-MIBG uptake

Eur Radiol. 2017 Dec;27(12):5073-5079. doi: 10.1007/s00330-017-4941-6. Epub 2017 Jul 4.

Abstract

Objective: Patients with Parkinson's disease (PD) may exhibit symptoms of sympathetic dysfunction that can be measured using 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy. We investigated the relationship between microstructural brain changes and 123I-MIBG uptake in patients with PD using voxel-based morphometry (VBM) and diffusion tensor imaging (DTI) analyses.

Methods: This retrospective study included 24 patients with PD who underwent 3 T magnetic resonance imaging and 123I-MIBG scintigraphy. They were divided into two groups: 12 MIBG-positive and 12 MIBG-negative cases (10 men and 14 women; age range: 60-81 years, corrected for gender and age). The heart/mediastinum count (H/M) ratio was calculated on anterior planar 123I-MIBG images obtained 4 h post-injection. VBM and DTI were performed to detect structural differences between these two groups.

Results: Patients with low H/M ratio had significantly reduced brain volume at the right inferior frontal gyrus (uncorrected p < 0.0001, K > 90). Patients with low H/M ratios also exhibited significantly lower fractional anisotropy than those with high H/M ratios (p < 0.05) at the left anterior thalamic radiation, the left inferior fronto-occipital fasciculus, the left superior longitudinal fasciculus, and the left uncinate fasciculus.

Conclusions: VBM and DTI may reveal microstructural changes related to the degree of 123I-MIBG uptake in patients with PD.

Key points: • Advanced MRI methods may detect brain damage more precisely. • Voxel-based morphometry can detect grey matter changes in Parkinson's disease. • Diffusion tensor imaging can detect white matter changes in Parkinson's disease.

Keywords: Diffusion tensor imaging; Magnetic resonance imaging; Neurodegenerative diseases; Parkinson’s disease; Radionuclide imaging.

Publication types

  • Evaluation Study

MeSH terms

  • 3-Iodobenzylguanidine / pharmacokinetics*
  • Adult
  • Aged
  • Aged, 80 and over
  • Anisotropy
  • Brain / pathology
  • Diffusion Tensor Imaging / methods
  • Female
  • Gray Matter / pathology
  • Humans
  • Iodine Radioisotopes / pharmacokinetics*
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Parkinson Disease / pathology*
  • Radionuclide Imaging / methods
  • Radiopharmaceuticals / pharmacokinetics*
  • Retrospective Studies
  • White Matter / pathology

Substances

  • Iodine Radioisotopes
  • Radiopharmaceuticals
  • 3-Iodobenzylguanidine