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Parkinsonism Relat Disord. 2014 Jan;20(1):53-9. doi: 10.1016/j.parkreldis.2013.09.017. Epub 2013 Sep 22.

Transcallosal diffusion tensor abnormalities in predominant gait disorder parkinsonism.

Author information

1
Department of Diagnostic Radiology, Singapore General Hospital, Republic of Singapore.
2
Department of Diagnostic Radiology, Singapore General Hospital, Republic of Singapore; Duke-NUS Graduate Medical School, Republic of Singapore.
3
Department of Clinical Research, Singapore General Hospital, Republic of Singapore.
4
Department of Neurology, Singapore General Hospital, Republic of Singapore; Department of Clinical Research, Singapore General Hospital, Republic of Singapore; National Neuroscience Institute, Republic of Singapore; Duke-NUS Graduate Medical School, Republic of Singapore. Electronic address: gnrtek@sgh.com.sg.

Abstract

BACKGROUND:

There have been no previous diffusion tensor imaging (DTI) studies comparing Parkinson's disease (PD) with postural instability and gait disorder (PIGD) parkinsonism.

OBJECTIVE:

Utilizing DTI with 2-region tractography, we conducted a case control study to determine if different brain regions representing the neural network of the motor system are differentially affected in PIGD compared to PD and controls.

METHODS:

On a 3 T MR machine, using manual ROI (regions of interest) we determined the fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values on DTI in anatomical brain regions representing the extrapyramidal, pyramidal, and transcallosal tracts, aided by 2-region tractography. FA and ADC were correlated with the Tinetti score (measure of gait and balance).

RESULTS:

Sixty-five subjects (21 PD, 25 PIGD, 19 controls) were included in the analysis. We demonstrated greater ADC abnormalities in the extrapyramidal, pyramidal and transcallosal motor systems in PIGD compared to controls. Multivariate analysis taking into consideration various clinical variables showed that the FA (p = 0.02) and ADC (p = 0.001) values in the corpus callosum body differentiated PIGD from PD. PIGD with low Tinetti score had a lower FA (p = 0.02) and a higher ADC value (corpus callosum body) (p = 0.03) compared to those with a high score.

CONCLUSIONS:

We demonstrated for the first time that DTI abnormalities along the transcallosal motor tract in the body of the corpus callosum, but not the substantia nigra, differentiated PIGD from PD, and the degree of corpus callosum body abnormality correlated with the Tinetti score (a measure of risk of falls).

KEYWORDS:

Diffusion tensor imaging; Gait disorder; Parkinson's disease; Postural instability

[Indexed for MEDLINE]

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