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<meta name="HW.identifier" content="/ajnr/40/4/609.atom" />
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<meta name="DC.Title" content="Periventricular White Matter Abnormalities on Diffusion Tensor Imaging of Postural Instability Gait Disorder Parkinsonism" />
<meta name="DC.Identifier" content="10.3174/ajnr.A5993" />
<meta name="DC.Date" content="2019-04-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2019 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: Postural instability gait disorder is a motor subtype of Parkinson disease associated with predominant gait dysfunction. We investigated the periventricular white matter comprising longitudinal, thalamic, and callosal fibers using diffusion tensor MR Imaging and examined clinical correlates in a cohort of patients with Parkinson disease and postural instability gait disorder and healthy controls.

MATERIALS AND METHODS: All subjects underwent the Tinetti Gait and Balance Assessment and brain MR imaging. The DTI indices (fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity) from ROIs dropped over the superior and inferior longitudinal fasciculi, inferior fronto-occipital fasciculus, anterior thalamic radiation, anterior and posterior limbs of the internal capsule, and the genu and body of corpus callosum were evaluated.

RESULTS: Our findings showed that the superior longitudinal fasciculus, inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, anterior thalamic radiation, genu of the corpus callosum, and body of the corpus callosum are more affected in postural instability gait disorder than in those with Parkinson disease or healthy controls, with more group differences among the longitudinal fibers. Only the callosal fibers differentiated the postural instability gait disorder and Parkinson disease groups. DTI measures in the superior longitudinal fasciculus, frontostriatal fibers (anterior thalamic radiation, anterior limb of the internal capsule), and genu of the corpus callosum fibers correlated with clinical gait severity.

CONCLUSIONS: Findings from this case-control cohort lend further evidence to the role of extranigral pathology and, specifically, the periventricular fibers in the pathophysiology of postural instability gait disorder.

AD
:   axial diffusivity
ALIC
:   anterior limb of the internal capsule
ATR
:   anterior thalamic radiation
BCC
:   body of the corpus callosum
FA
:   fractional anisotropy
GCC
:   genu of the corpus callosum
HC
:   healthy controls
IFOF
:   inferior fronto-occipital fasciculus
ILF
:   inferior longitudinal fasciculus
MD
:   mean diffusivity
PIGD
:   postural instability gait disorder
PD
:   Parkinson disease
PLIC
:   posterior limb of the internal capsule
RD
:   radial diffusivity
SLF
:   superior longitudinal fasciculus" />
<meta name="DC.Contributor" content="S.Y.Z. Tan" />
<meta name="DC.Contributor" content="N.C.H. Keong" />
<meta name="DC.Contributor" content="R.M.P. Selvan" />
<meta name="DC.Contributor" content="H. Li" />
<meta name="DC.Contributor" content="L.Q.R. Ooi" />
<meta name="DC.Contributor" content="E.K. Tan" />
<meta name="DC.Contributor" content="L.L. Chan" />
<meta name="article:published_time" content="2019-04-01" />
<meta name="article:section" content="Adult Brain" />
<meta name="citation_title" content="Periventricular White Matter Abnormalities on Diffusion Tensor Imaging of Postural Instability Gait Disorder Parkinsonism" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Postural instability gait disorder is a motor subtype of Parkinson disease associated with predominant gait dysfunction. We investigated the periventricular white matter comprising longitudinal, thalamic, and callosal fibers using diffusion tensor MR Imaging and examined clinical correlates in a cohort of patients with Parkinson disease and postural instability gait disorder and healthy controls.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;All subjects underwent the Tinetti Gait and Balance Assessment and brain MR imaging. The DTI indices (fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity) from ROIs dropped over the superior and inferior longitudinal fasciculi, inferior fronto-occipital fasciculus, anterior thalamic radiation, anterior and posterior limbs of the internal capsule, and the genu and body of corpus callosum were evaluated.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Our findings showed that the superior longitudinal fasciculus, inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, anterior thalamic radiation, genu of the corpus callosum, and body of the corpus callosum are more affected in postural instability gait disorder than in those with Parkinson disease or healthy controls, with more group differences among the longitudinal fibers. Only the callosal fibers differentiated the postural instability gait disorder and Parkinson disease groups. DTI measures in the superior longitudinal fasciculus, frontostriatal fibers (anterior thalamic radiation, anterior limb of the internal capsule), and genu of the corpus callosum fibers correlated with clinical gait severity.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Findings from this case-control cohort lend further evidence to the role of extranigral pathology and, specifically, the periventricular fibers in the pathophysiology of postural instability gait disorder.&lt;/p&gt;" />
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<meta name="twitter:title" content="Periventricular White Matter Abnormalities on Diffusion Tensor Imaging of Postural Instability Gait Disorder Parkinsonism" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Postural instability gait disorder is a motor subtype of Parkinson disease associated with predominant gait dysfunction. We investigated the periventricular white matter comprising longitudinal, thalamic, and callosal fibers using diffusion tensor MR Imaging and examined clinical correlates in a cohort of patients with Parkinson disease and postural instability gait disorder and healthy controls.

MATERIALS AND METHODS: All subjects underwent the Tinetti Gait and Balance Assessment and brain MR imaging. The DTI indices (fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity) from ROIs dropped over the superior and inferior longitudinal fasciculi, inferior fronto-occipital fasciculus, anterior thalamic radiation, anterior and posterior limbs of the internal capsule, and the genu and body of corpus callosum were evaluated.

RESULTS: Our findings showed that the superior longitudinal fasciculus, inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, anterior thalamic radiation, genu of the corpus callosum, and body of the corpus callosum are more affected in postural instability gait disorder than in those with Parkinson disease or healthy controls, with more group differences among the longitudinal fibers. Only the callosal fibers differentiated the postural instability gait disorder and Parkinson disease groups. DTI measures in the superior longitudinal fasciculus, frontostriatal fibers (anterior thalamic radiation, anterior limb of the internal capsule), and genu of the corpus callosum fibers correlated with clinical gait severity.

CONCLUSIONS: Findings from this case-control cohort lend further evidence to the role of extranigral pathology and, specifically, the periventricular fibers in the pathophysiology of postural instability gait disorder.

AD
:   axial diffusivity
ALIC
:   anterior limb of the internal capsule
ATR
:   anterior thalamic radiation
BCC
:   body of the corpus callosum
FA
:   fractional anisotropy
GCC
:   genu of the corpus callosum
HC
:   healthy controls
IFOF
:   inferior fronto-occipital fasciculus
ILF
:   inferior longitudinal fasciculus
MD
:   mean diffusivity
PIGD
:   postural instability gait disorder
PD
:   Parkinson disease
PLIC
:   posterior limb of the internal capsule
RD
:   radial diffusivity
SLF
:   superior longitudinal fasciculus" />
<meta name="og-title" property="og:title" content="Periventricular White Matter Abnormalities on Diffusion Tensor Imaging of Postural Instability Gait Disorder Parkinsonism" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/40/4/609" />
<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: Postural instability gait disorder is a motor subtype of Parkinson disease associated with predominant gait dysfunction. We investigated the periventricular white matter comprising longitudinal, thalamic, and callosal fibers using diffusion tensor MR Imaging and examined clinical correlates in a cohort of patients with Parkinson disease and postural instability gait disorder and healthy controls.

MATERIALS AND METHODS: All subjects underwent the Tinetti Gait and Balance Assessment and brain MR imaging. The DTI indices (fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity) from ROIs dropped over the superior and inferior longitudinal fasciculi, inferior fronto-occipital fasciculus, anterior thalamic radiation, anterior and posterior limbs of the internal capsule, and the genu and body of corpus callosum were evaluated.

RESULTS: Our findings showed that the superior longitudinal fasciculus, inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, anterior thalamic radiation, genu of the corpus callosum, and body of the corpus callosum are more affected in postural instability gait disorder than in those with Parkinson disease or healthy controls, with more group differences among the longitudinal fibers. Only the callosal fibers differentiated the postural instability gait disorder and Parkinson disease groups. DTI measures in the superior longitudinal fasciculus, frontostriatal fibers (anterior thalamic radiation, anterior limb of the internal capsule), and genu of the corpus callosum fibers correlated with clinical gait severity.

CONCLUSIONS: Findings from this case-control cohort lend further evidence to the role of extranigral pathology and, specifically, the periventricular fibers in the pathophysiology of postural instability gait disorder.

AD
:   axial diffusivity
ALIC
:   anterior limb of the internal capsule
ATR
:   anterior thalamic radiation
BCC
:   body of the corpus callosum
FA
:   fractional anisotropy
GCC
:   genu of the corpus callosum
HC
:   healthy controls
IFOF
:   inferior fronto-occipital fasciculus
ILF
:   inferior longitudinal fasciculus
MD
:   mean diffusivity
PIGD
:   postural instability gait disorder
PD
:   Parkinson disease
PLIC
:   posterior limb of the internal capsule
RD
:   radial diffusivity
SLF
:   superior longitudinal fasciculus" />
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">S.Y.Z. Tan</span>, <span class="highwire-citation-author" data-delta="1">N.C.H. Keong</span>, <span class="highwire-citation-author" data-delta="2">R.M.P. Selvan</span>, <span class="highwire-citation-author" data-delta="3">H. Li</span>, <span class="highwire-citation-author" data-delta="4">L.Q.R. Ooi</span>, <span class="highwire-citation-author" data-delta="5">E.K. Tan</span> and <span class="highwire-citation-author" data-delta="6">L.L. Chan</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">April 2019,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">40 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(4) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">609-613; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A5993 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-66928--6142299839" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">S.Y.Z. Tan </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Diagnostic Radiology, Singapore General Hospital, Singhealth (S.Y.Z.T., N.C.H.K., H.L., E.K.T., L.L.C.), Singapore</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.Y.Z.%2BTan%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=Tan%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.Y.Z.%2BTan%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/0000-0002-8172-2288" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S.Y.Z. Tan</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">N.C.H. Keong </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Diagnostic Radiology, Singapore General Hospital, Singhealth (S.Y.Z.T., N.C.H.K., H.L., E.K.T., L.L.C.), Singapore</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Departments of Neurosurgery, Research and Neurology, National Neuroscience Institute, Singhealth (N.C.H.K., R.M.P.S., L.Q.R.O., E.K.T.), Singapore</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Duke-NUS Medical School (N.C.H.K., E.K.T., L.L.C.), Singapore.</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.C.H.%2BKeong%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=Keong%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.C.H.%2BKeong%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/0000-0002-1250-2441" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for N.C.H. Keong</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">R.M.P. Selvan </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Departments of Neurosurgery, Research and Neurology, National Neuroscience Institute, Singhealth (N.C.H.K., R.M.P.S., L.Q.R.O., E.K.T.), Singapore</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.M.P.%2BSelvan%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=Selvan%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.M.P.%2BSelvan%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/0000-0002-9816-9925" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for R.M.P. Selvan</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">H. Li </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Diagnostic Radiology, Singapore General Hospital, Singhealth (S.Y.Z.T., N.C.H.K., H.L., E.K.T., L.L.C.), Singapore</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=H.%2BLi%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=Li%20H&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%3AH.%2BLi%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/0000-0003-4021-7290" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for H. Li</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">L.Q.R. Ooi </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Departments of Neurosurgery, Research and Neurology, National Neuroscience Institute, Singhealth (N.C.H.K., R.M.P.S., L.Q.R.O., E.K.T.), Singapore</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.Q.R.%2BOoi%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=Ooi%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.Q.R.%2BOoi%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/0000-0002-3546-4580" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for L.Q.R. Ooi</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">E.K. Tan </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Diagnostic Radiology, Singapore General Hospital, Singhealth (S.Y.Z.T., N.C.H.K., H.L., E.K.T., L.L.C.), Singapore</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Departments of Neurosurgery, Research and Neurology, National Neuroscience Institute, Singhealth (N.C.H.K., R.M.P.S., L.Q.R.O., E.K.T.), Singapore</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Duke-NUS Medical School (N.C.H.K., E.K.T., L.L.C.), Singapore.</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=E.K.%2BTan%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=Tan%20E&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%3AE.K.%2BTan%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/0000-0003-2977-9743" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for E.K. Tan</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">L.L. Chan </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Diagnostic Radiology, Singapore General Hospital, Singhealth (S.Y.Z.T., N.C.H.K., H.L., E.K.T., L.L.C.), Singapore</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Duke-NUS Medical School (N.C.H.K., E.K.T., L.L.C.), Singapore.</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.L.%2BChan%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=Chan%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.L.%2BChan%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/0000-0001-7603-7334" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for L.L. 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    	<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">Apr 2019, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">40 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(4) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">609-613; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5993 </span></div>
  
  
  
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