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<meta name="DC.Title" content="Comparative Study of MRI Biomarkers in the Substantia Nigra to Discriminate Idiopathic Parkinson Disease" />
<meta name="DC.Identifier" content="10.3174/ajnr.A5702" />
<meta name="DC.Date" content="2018-08-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2018 by American Journal of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org" />
<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Several new MR imaging techniques have shown promising results in patients with Parkinson disease; however, the comparative diagnostic values of these measures at the individual level remain unclear. Our aim was to compare the diagnostic value of MR imaging biomarkers of substantia nigra damage for distinguishing patients with Parkinson disease from healthy volunteers.

MATERIALS AND METHODS: Thirty-six patients and 20 healthy volunteers were prospectively included. The MR imaging protocol at 3T included 3D T2-weighted and T1-weighted neuromelanin-sensitive images, diffusion tensor images, and R2* mapping. T2* high-resolution images were also acquired at 7T to evaluate the dorsal nigral hyperintensity sign. Quantitative analysis was performed using ROIs in the substantia nigra drawn manually around the area of high signal intensity on neuromelanin-sensitive images and T2-weighted images. Visual analysis of the substantia nigra neuromelanin-sensitive signal intensity and the dorsolateral nigral hyperintensity on T2* images was performed.

RESULTS: There was a significant decrease in the neuromelanin-sensitive volume and signal intensity in patients with Parkinson disease. There was also a significant decrease in fractional anisotropy and an increase in mean, axial, and radial diffusivity in the neuromelanin-sensitive substantia nigra at 3T and a decrease in substantia nigra volume on T2* images. The combination of substantia nigra volume, signal intensity, and fractional anisotropy in the neuromelanin-sensitive substantia nigra allowed excellent diagnostic accuracy (0.93). Visual assessment of both substantia nigra dorsolateral hyperintensity and neuromelanin-sensitive images had good diagnostic accuracy (0.91 and 0.86, respectively).

CONCLUSIONS: The combination of neuromelanin signal and volume changes with fractional anisotropy measurements in the substantia nigra showed excellent diagnostic accuracy. Moreover, the high diagnostic accuracy of visual assessment of substantia nigra changes using dorsolateral hyperintensity analysis or neuromelanin-sensitive signal changes indicates that these techniques are promising for clinical practice.

AD
:   axial diffusivity
DNH
:   dorsal nigral hyperintensity
FA
:   fractional anisotropy
ICC
:   intraclass correlation coefficient
HV
:   healthy volunteer
MD
:   mean diffusivity
NM
:   neuromelanin
PD
:   Parkinson disease
RD
:   radial diffusivity
ROC
:   receiver operating characteristic
SN
:   substantia nigra
UPDRS
:   Unified Parkinson's Disease Rating Scale" />
<meta name="DC.Contributor" content="N. Pyatigorskaya" />
<meta name="DC.Contributor" content="B. Magnin" />
<meta name="DC.Contributor" content="M. Mongin" />
<meta name="DC.Contributor" content="L. Yahia-Cherif" />
<meta name="DC.Contributor" content="R. Valabregue" />
<meta name="DC.Contributor" content="D. Arnaldi" />
<meta name="DC.Contributor" content="C. Ewenczyk" />
<meta name="DC.Contributor" content="C. Poupon" />
<meta name="DC.Contributor" content="M. Vidailhet" />
<meta name="DC.Contributor" content="S. Lehéricy" />
<meta name="article:published_time" content="2018-08-01" />
<meta name="article:section" content="Adult Brain" />
<meta name="citation_title" content="Comparative Study of MRI Biomarkers in the Substantia Nigra to Discriminate Idiopathic Parkinson Disease" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Several new MR imaging techniques have shown promising results in patients with Parkinson disease; however, the comparative diagnostic values of these measures at the individual level remain unclear. Our aim was to compare the diagnostic value of MR imaging biomarkers of substantia nigra damage for distinguishing patients with Parkinson disease from healthy volunteers.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Thirty-six patients and 20 healthy volunteers were prospectively included. The MR imaging protocol at 3T included 3D T2-weighted and T1-weighted neuromelanin-sensitive images, diffusion tensor images, and R2* mapping. T2* high-resolution images were also acquired at 7T to evaluate the dorsal nigral hyperintensity sign. Quantitative analysis was performed using ROIs in the substantia nigra drawn manually around the area of high signal intensity on neuromelanin-sensitive images and T2-weighted images. Visual analysis of the substantia nigra neuromelanin-sensitive signal intensity and the dorsolateral nigral hyperintensity on T2* images was performed.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;There was a significant decrease in the neuromelanin-sensitive volume and signal intensity in patients with Parkinson disease. There was also a significant decrease in fractional anisotropy and an increase in mean, axial, and radial diffusivity in the neuromelanin-sensitive substantia nigra at 3T and a decrease in substantia nigra volume on T2* images. The combination of substantia nigra volume, signal intensity, and fractional anisotropy in the neuromelanin-sensitive substantia nigra allowed excellent diagnostic accuracy (0.93). Visual assessment of both substantia nigra dorsolateral hyperintensity and neuromelanin-sensitive images had good diagnostic accuracy (0.91 and 0.86, respectively).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;The combination of neuromelanin signal and volume changes with fractional anisotropy measurements in the substantia nigra showed excellent diagnostic accuracy. Moreover, the high diagnostic accuracy of visual assessment of substantia nigra changes using dorsolateral hyperintensity analysis or neuromelanin-sensitive signal changes indicates that these techniques are promising for clinical practice.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_publication_date" content="2018/08/01" />
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<meta name="citation_author" content="N. Pyatigorskaya" />
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<meta name="twitter:title" content="Comparative Study of MRI Biomarkers in the Substantia Nigra to Discriminate Idiopathic Parkinson Disease" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Several new MR imaging techniques have shown promising results in patients with Parkinson disease; however, the comparative diagnostic values of these measures at the individual level remain unclear. Our aim was to compare the diagnostic value of MR imaging biomarkers of substantia nigra damage for distinguishing patients with Parkinson disease from healthy volunteers.

MATERIALS AND METHODS: Thirty-six patients and 20 healthy volunteers were prospectively included. The MR imaging protocol at 3T included 3D T2-weighted and T1-weighted neuromelanin-sensitive images, diffusion tensor images, and R2* mapping. T2* high-resolution images were also acquired at 7T to evaluate the dorsal nigral hyperintensity sign. Quantitative analysis was performed using ROIs in the substantia nigra drawn manually around the area of high signal intensity on neuromelanin-sensitive images and T2-weighted images. Visual analysis of the substantia nigra neuromelanin-sensitive signal intensity and the dorsolateral nigral hyperintensity on T2* images was performed.

RESULTS: There was a significant decrease in the neuromelanin-sensitive volume and signal intensity in patients with Parkinson disease. There was also a significant decrease in fractional anisotropy and an increase in mean, axial, and radial diffusivity in the neuromelanin-sensitive substantia nigra at 3T and a decrease in substantia nigra volume on T2* images. The combination of substantia nigra volume, signal intensity, and fractional anisotropy in the neuromelanin-sensitive substantia nigra allowed excellent diagnostic accuracy (0.93). Visual assessment of both substantia nigra dorsolateral hyperintensity and neuromelanin-sensitive images had good diagnostic accuracy (0.91 and 0.86, respectively).

CONCLUSIONS: The combination of neuromelanin signal and volume changes with fractional anisotropy measurements in the substantia nigra showed excellent diagnostic accuracy. Moreover, the high diagnostic accuracy of visual assessment of substantia nigra changes using dorsolateral hyperintensity analysis or neuromelanin-sensitive signal changes indicates that these techniques are promising for clinical practice.

AD
:   axial diffusivity
DNH
:   dorsal nigral hyperintensity
FA
:   fractional anisotropy
ICC
:   intraclass correlation coefficient
HV
:   healthy volunteer
MD
:   mean diffusivity
NM
:   neuromelanin
PD
:   Parkinson disease
RD
:   radial diffusivity
ROC
:   receiver operating characteristic
SN
:   substantia nigra
UPDRS
:   Unified Parkinson's Disease Rating Scale" />
<meta name="og-title" property="og:title" content="Comparative Study of MRI Biomarkers in the Substantia Nigra to Discriminate Idiopathic Parkinson Disease" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/39/8/1460" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Several new MR imaging techniques have shown promising results in patients with Parkinson disease; however, the comparative diagnostic values of these measures at the individual level remain unclear. Our aim was to compare the diagnostic value of MR imaging biomarkers of substantia nigra damage for distinguishing patients with Parkinson disease from healthy volunteers.

MATERIALS AND METHODS: Thirty-six patients and 20 healthy volunteers were prospectively included. The MR imaging protocol at 3T included 3D T2-weighted and T1-weighted neuromelanin-sensitive images, diffusion tensor images, and R2* mapping. T2* high-resolution images were also acquired at 7T to evaluate the dorsal nigral hyperintensity sign. Quantitative analysis was performed using ROIs in the substantia nigra drawn manually around the area of high signal intensity on neuromelanin-sensitive images and T2-weighted images. Visual analysis of the substantia nigra neuromelanin-sensitive signal intensity and the dorsolateral nigral hyperintensity on T2* images was performed.

RESULTS: There was a significant decrease in the neuromelanin-sensitive volume and signal intensity in patients with Parkinson disease. There was also a significant decrease in fractional anisotropy and an increase in mean, axial, and radial diffusivity in the neuromelanin-sensitive substantia nigra at 3T and a decrease in substantia nigra volume on T2* images. The combination of substantia nigra volume, signal intensity, and fractional anisotropy in the neuromelanin-sensitive substantia nigra allowed excellent diagnostic accuracy (0.93). Visual assessment of both substantia nigra dorsolateral hyperintensity and neuromelanin-sensitive images had good diagnostic accuracy (0.91 and 0.86, respectively).

CONCLUSIONS: The combination of neuromelanin signal and volume changes with fractional anisotropy measurements in the substantia nigra showed excellent diagnostic accuracy. Moreover, the high diagnostic accuracy of visual assessment of substantia nigra changes using dorsolateral hyperintensity analysis or neuromelanin-sensitive signal changes indicates that these techniques are promising for clinical practice.

AD
:   axial diffusivity
DNH
:   dorsal nigral hyperintensity
FA
:   fractional anisotropy
ICC
:   intraclass correlation coefficient
HV
:   healthy volunteer
MD
:   mean diffusivity
NM
:   neuromelanin
PD
:   Parkinson disease
RD
:   radial diffusivity
ROC
:   receiver operating characteristic
SN
:   substantia nigra
UPDRS
:   Unified Parkinson's Disease Rating Scale" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node62118--5" data-node-nid="62118" id="top-node-62118--61244671093" data-pisa="ajnr;39/8/1460" data-pisa-master="ajnr;ajnr.A5702" data-apath="/ajnr/39/8/1460.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Adult Brain</span></span></div>
  
      <div class="highwire-cite-access"><span class="highwire-citation-access"><i class="highwire-access-icon highwire-access-icon-open-access open-access hw-icon-open-access" title="Open Access" aria-hidden="true"></i><span  class="element-invisible highwire-access-icon highwire-access-icon-open-access" style="">Open Access</span></span></div>
  
      <h1 class="highwire-cite-title" id="page-title">Comparative Study of MRI Biomarkers in the Substantia Nigra to Discriminate Idiopathic Parkinson Disease</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">N. Pyatigorskaya</span>, <span class="highwire-citation-author" data-delta="1">B. Magnin</span>, <span class="highwire-citation-author" data-delta="2">M. Mongin</span>, <span class="highwire-citation-author" data-delta="3">L. Yahia-Cherif</span>, <span class="highwire-citation-author" data-delta="4">R. Valabregue</span>, <span class="highwire-citation-author" data-delta="5">D. Arnaldi</span>, <span class="highwire-citation-author" data-delta="6">C. Ewenczyk</span>, <span class="highwire-citation-author" data-delta="7">C. Poupon</span>, <span class="highwire-citation-author" data-delta="8">M. Vidailhet</span> and <span class="highwire-citation-author" data-delta="9">S. Lehéricy</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">August 2018,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">39 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1460-1467; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A5702 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-62118--61244671093" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">N. Pyatigorskaya </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Institut du Cerveau et de la Moelle épinière (N.P., B.M., M.M., L.Y.-C., R.V., D.A., M.V., S.L.), Centre de NeuroImagerie de Recherche, Paris, France</div><div class='author-affiliation'><span class='nlm-sup'>b</span>UMR S 1127, CNRS UMR 7225 (N.P., B.M., M.M., L.Y.-C., M.V., S.L.), Sorbonne University, Paris, France</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Service de neuroradiologie (N.P., B.M., S.L.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=N.%2BPyatigorskaya%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Pyatigorskaya%20N&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AN.%2BPyatigorskaya%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-2070-1299" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for N. Pyatigorskaya</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">B. Magnin </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Institut du Cerveau et de la Moelle épinière (N.P., B.M., M.M., L.Y.-C., R.V., D.A., M.V., S.L.), Centre de NeuroImagerie de Recherche, Paris, France</div><div class='author-affiliation'><span class='nlm-sup'>b</span>UMR S 1127, CNRS UMR 7225 (N.P., B.M., M.M., L.Y.-C., M.V., S.L.), Sorbonne University, Paris, France</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Service de neuroradiologie (N.P., B.M., S.L.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=B.%2BMagnin%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Magnin%20B&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AB.%2BMagnin%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-4246-5688" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for B. Magnin</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">M. Mongin </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Institut du Cerveau et de la Moelle épinière (N.P., B.M., M.M., L.Y.-C., R.V., D.A., M.V., S.L.), Centre de NeuroImagerie de Recherche, Paris, France</div><div class='author-affiliation'><span class='nlm-sup'>b</span>UMR S 1127, CNRS UMR 7225 (N.P., B.M., M.M., L.Y.-C., M.V., S.L.), Sorbonne University, Paris, France</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BMongin%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Mongin%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.%2BMongin%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-2338-5321" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. Mongin</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">L. Yahia-Cherif </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Institut du Cerveau et de la Moelle épinière (N.P., B.M., M.M., L.Y.-C., R.V., D.A., M.V., S.L.), Centre de NeuroImagerie de Recherche, Paris, France</div><div class='author-affiliation'><span class='nlm-sup'>b</span>UMR S 1127, CNRS UMR 7225 (N.P., B.M., M.M., L.Y.-C., M.V., S.L.), Sorbonne University, Paris, France</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=L.%2BYahia-Cherif%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Yahia-Cherif%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AL.%2BYahia-Cherif%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-7107-7588" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for L. Yahia-Cherif</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">R. Valabregue </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Institut du Cerveau et de la Moelle épinière (N.P., B.M., M.M., L.Y.-C., R.V., D.A., M.V., S.L.), Centre de NeuroImagerie de Recherche, Paris, France</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=R.%2BValabregue%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Valabregue%20R&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AR.%2BValabregue%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-1814-9570" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for R. Valabregue</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">D. Arnaldi </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Institut du Cerveau et de la Moelle épinière (N.P., B.M., M.M., L.Y.-C., R.V., D.A., M.V., S.L.), Centre de NeuroImagerie de Recherche, Paris, France</div><div class='author-affiliation'><span class='nlm-sup'>e</span>Clinical Neurology (D.A.), Department of Neuroscience, University of Genoa, Genoa, Italy</div><div class='author-affiliation'><span class='nlm-sup'>g</span>Centre d'Investigation Clinique (D.A., M.V.), Hôpital Pitié-Salpêtrière, Paris, France.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.%2BArnaldi%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Arnaldi%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AD.%2BArnaldi%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-6823-6069" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for D. Arnaldi</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">C. Ewenczyk </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Département des Maladies du Système Nerveux (C.E., M.V.), Clinique des mouvements anormaux, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.%2BEwenczyk%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Ewenczyk%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AC.%2BEwenczyk%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-4864-6287" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C. Ewenczyk</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">C. Poupon </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>f</span>NeuroSpin (C.P.), Commissariat à l'Energie Atomique, Gif-Sur-Yvette, France</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.%2BPoupon%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Poupon%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AC.%2BPoupon%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-7906-8945" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C. Poupon</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">M. Vidailhet </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Institut du Cerveau et de la Moelle épinière (N.P., B.M., M.M., L.Y.-C., R.V., D.A., M.V., S.L.), Centre de NeuroImagerie de Recherche, Paris, France</div><div class='author-affiliation'><span class='nlm-sup'>b</span>UMR S 1127, CNRS UMR 7225 (N.P., B.M., M.M., L.Y.-C., M.V., S.L.), Sorbonne University, Paris, France</div><div class='author-affiliation'><span class='nlm-sup'>d</span>Département des Maladies du Système Nerveux (C.E., M.V.), Clinique des mouvements anormaux, Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France</div><div class='author-affiliation'><span class='nlm-sup'>g</span>Centre d'Investigation Clinique (D.A., M.V.), Hôpital Pitié-Salpêtrière, Paris, France.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BVidailhet%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Vidailhet%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.%2BVidailhet%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-2409-9143" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. Vidailhet</a></li></ul></div><div class="author-tooltip-9"><div class="author-tooltip-name">S. Lehéricy </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Institut du Cerveau et de la Moelle épinière (N.P., B.M., M.M., L.Y.-C., R.V., D.A., M.V., S.L.), Centre de NeuroImagerie de Recherche, Paris, France</div><div class='author-affiliation'><span class='nlm-sup'>b</span>UMR S 1127, CNRS UMR 7225 (N.P., B.M., M.M., L.Y.-C., M.V., S.L.), Sorbonne University, Paris, France</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Service de neuroradiologie (N.P., B.M., S.L.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.%2BLeh%C3%A9ricy%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Leh%C3%A9ricy%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AS.%2BLeh%25C3%25A9ricy%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-5802-3518" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S. Lehéricy</a></li></ul></div></div></div>  </div>

  
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Our aim was to compare the diagnostic value of MR imaging biomarkers of substantia nigra damage for distinguishing patients with Parkinson disease from healthy volunteers.</p></div><div id="sec-2" class="subsection"><p id="p-3"><strong>MATERIALS AND METHODS:</strong> Thirty-six patients and 20 healthy volunteers were prospectively included. The MR imaging protocol at 3T included 3D T2-weighted and T1-weighted neuromelanin-sensitive images, diffusion tensor images, and R2* mapping. T2* high-resolution images were also acquired at 7T to evaluate the dorsal nigral hyperintensity sign. Quantitative analysis was performed using ROIs in the substantia nigra drawn manually around the area of high signal intensity on neuromelanin-sensitive images and T2-weighted images. Visual analysis of the substantia nigra neuromelanin-sensitive signal intensity and the dorsolateral nigral hyperintensity on T2* images was performed.</p></div><div id="sec-3" class="subsection"><p id="p-4"><strong>RESULTS:</strong> There was a significant decrease in the neuromelanin-sensitive volume and signal intensity in patients with Parkinson disease. There was also a significant decrease in fractional anisotropy and an increase in mean, axial, and radial diffusivity in the neuromelanin-sensitive substantia nigra at 3T and a decrease in substantia nigra volume on T2* images. The combination of substantia nigra volume, signal intensity, and fractional anisotropy in the neuromelanin-sensitive substantia nigra allowed excellent diagnostic accuracy (0.93). Visual assessment of both substantia nigra dorsolateral hyperintensity and neuromelanin-sensitive images had good diagnostic accuracy (0.91 and 0.86, respectively).</p></div><div id="sec-4" class="subsection"><p id="p-5"><strong>CONCLUSIONS:</strong> The combination of neuromelanin signal and volume changes with fractional anisotropy measurements in the substantia nigra showed excellent diagnostic accuracy. Moreover, the high diagnostic accuracy of visual assessment of substantia nigra changes using dorsolateral hyperintensity analysis or neuromelanin-sensitive signal changes indicates that these techniques are promising for clinical practice.</p></div></div><div class="section glossary" id="glossary-1"><h2 class="">ABBREVIATIONS:</h2><dl id="def-list-1"><dt id="def-item-1">AD<span class="def-item-dt-sep"></span></dt><dd>axial diffusivity<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">DNH<span class="def-item-dt-sep"></span></dt><dd>dorsal nigral hyperintensity<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">FA<span class="def-item-dt-sep"></span></dt><dd>fractional anisotropy<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">ICC<span class="def-item-dt-sep"></span></dt><dd>intraclass correlation coefficient<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">HV<span class="def-item-dt-sep"></span></dt><dd>healthy volunteer<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">MD<span class="def-item-dt-sep"></span></dt><dd>mean diffusivity<span class="def-item-dd-sep"></span></dd><dt id="def-item-7">NM<span class="def-item-dt-sep"></span></dt><dd>neuromelanin<span class="def-item-dd-sep"></span></dd><dt id="def-item-8">PD<span class="def-item-dt-sep"></span></dt><dd>Parkinson disease<span class="def-item-dd-sep"></span></dd><dt id="def-item-9">RD<span class="def-item-dt-sep"></span></dt><dd>radial diffusivity<span class="def-item-dd-sep"></span></dd><dt id="def-item-10">ROC<span class="def-item-dt-sep"></span></dt><dd>receiver operating characteristic<span class="def-item-dd-sep"></span></dd><dt id="def-item-11">SN<span class="def-item-dt-sep"></span></dt><dd>substantia nigra<span class="def-item-dd-sep"></span></dd><dt id="def-item-12">UPDRS<span class="def-item-dt-sep"></span></dt><dd>Unified Parkinson's Disease Rating Scale</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2018 by American Journal of Neuroradiology</li></ul><div class="license" id="license-1"><p id="p-1">Indicates open access to non-subscribers at <a href="http://www.ajnr.org" rel="license">www.ajnr.org</a></p></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/39/8/1460.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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      <div class="highwire-cite-title">Comparative Study of MRI Biomarkers in the Substantia Nigra to Discriminate Idiopathic Parkinson Disease</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">N.</span> <span class="nlm-surname">Pyatigorskaya</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">B.</span> <span class="nlm-surname">Magnin</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Mongin</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Yahia-Cherif</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Valabregue</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">D.</span> <span class="nlm-surname">Arnaldi</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Ewenczyk</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Poupon</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Vidailhet</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Lehéricy</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Aug 2018, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">39 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1460-1467; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5702 </span></div>
  
  
  
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">N.</span> <span class="nlm-surname">Pyatigorskaya</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">B.</span> <span class="nlm-surname">Magnin</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Mongin</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Yahia-Cherif</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Valabregue</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">D.</span> <span class="nlm-surname">Arnaldi</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Ewenczyk</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Poupon</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Vidailhet</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Lehéricy</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Aug 2018, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">39 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1460-1467; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5702 </span></div>
  
  
  
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