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<meta name="DC.Title" content="Structural Brain Abnormalities in Patients with Parkinson Disease: A Comparative Voxel-Based Analysis Using T1-Weighted MR Imaging and Magnetization Transfer Imaging" />
<meta name="DC.Identifier" content="10.3174/ajnr.A2837" />
<meta name="DC.Date" content="2011-11-11" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: In PD, tissue damage occurs in specific cortical and subcortical regions. Conventional MR images have only limited capacity to depict these structural changes. The purpose of the current study was to investigate whether voxel-based MT imaging could indicate structural abnormalities beyond atrophy measurable with T1-weighted MR imaging.

MATERIALS AND METHODS: Thirty-six patients with PD without dementia (9 in H&amp;Y stage 1, thirteen in H&amp;Y 2, eleven in H&amp;Y 3, three in H&amp;Y 4) and 23 age-matched control subjects were studied with T1-weighted MR imaging and MT imaging. Voxel-based analyses of T1-weighted MR imaging was performed to investigate brain atrophy, while MT imaging was used to study abnormalities within existing tissue. Modulated GM and WM probability maps, sensitive to volume, and nonmodulated maps, indicative of tissue density, were obtained from T1-weighted MR imaging. Effects seen on MTR images, but absent on density maps, were attributed to damage of existing tissue.

RESULTS: Contrary to T1-weighted MR imaging, MT imaging was sensitive to the progression of brain pathology of the neocortex and paraventricular WM. MTR images and T1-based volume images, but not density images, showed a progression of disease in the olfactory cortex, indicating the occurrence of atrophy as well as damage to existing tissue in this region. MTR images revealed bilateral damage to the SN, while T1-weighted MR imaging only showed left-sided abnormalities.

CONCLUSIONS: The findings suggest that voxel-based MT imaging permits a whole-brain unbiased investigation of CNS structural integrity in PD and may be a valuable tool for identifying structural damage occurring without or before measurable atrophy.

### Abbreviations

FWHM
:   full width at half maximum
FWE
:   family-wise error
H&amp;Y
:   Hoehn and Yahr
GM
:   gray matter
ILF
:   inferior longitudinal fascicle
MMSE
:   Mini-Mental State Examination
MPRAGE
:   magnetization-prepared rapid acquisition of gradient echo
MT
:   magnetization transfer
MTR
:   magnetization transfer ratio
PD
:   Parkinson disease
SN
:   substantia nigra
SNc
:   substantia nigra, pars compacta
STG
:   superior temporal gyrus
UPDRS
:   United Parkinson Disease Rating Scale
VBM
:   voxel-based morphometry" />
<meta name="DC.Contributor" content="K. Morgen" />
<meta name="DC.Contributor" content="G. Sammer" />
<meta name="DC.Contributor" content="L. Weber" />
<meta name="DC.Contributor" content="B. Aslan" />
<meta name="DC.Contributor" content="C. Müller" />
<meta name="DC.Contributor" content="G.F. Bachmann" />
<meta name="DC.Contributor" content="D. Sandmann" />
<meta name="DC.Contributor" content="M. Oechsner" />
<meta name="DC.Contributor" content="D. Vaitl" />
<meta name="DC.Contributor" content="M. Kaps" />
<meta name="DC.Contributor" content="I. Reuter" />
<meta name="article:published_time" content="2011-11-09" />
<meta name="article:section" content="BRAIN" />
<meta name="citation_title" content="Structural Brain Abnormalities in Patients with Parkinson Disease: A Comparative Voxel-Based Analysis Using T1-Weighted MR Imaging and Magnetization Transfer Imaging" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;In PD, tissue damage occurs in specific cortical and subcortical regions. Conventional MR images have only limited capacity to depict these structural changes. The purpose of the current study was to investigate whether voxel-based MT imaging could indicate structural abnormalities beyond atrophy measurable with T1-weighted MR imaging.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Thirty-six patients with PD without dementia (9 in H&amp;amp;Y stage 1, thirteen in H&amp;amp;Y 2, eleven in H&amp;amp;Y 3, three in H&amp;amp;Y 4) and 23 age-matched control subjects were studied with T1-weighted MR imaging and MT imaging. Voxel-based analyses of T1-weighted MR imaging was performed to investigate brain atrophy, while MT imaging was used to study abnormalities within existing tissue. Modulated GM and WM probability maps, sensitive to volume, and nonmodulated maps, indicative of tissue density, were obtained from T1-weighted MR imaging. Effects seen on MTR images, but absent on density maps, were attributed to damage of existing tissue.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Contrary to T1-weighted MR imaging, MT imaging was sensitive to the progression of brain pathology of the neocortex and paraventricular WM. MTR images and T1-based volume images, but not density images, showed a progression of disease in the olfactory cortex, indicating the occurrence of atrophy as well as damage to existing tissue in this region. MTR images revealed bilateral damage to the SN, while T1-weighted MR imaging only showed left-sided abnormalities.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;The findings suggest that voxel-based MT imaging permits a whole-brain unbiased investigation of CNS structural integrity in PD and may be a valuable tool for identifying structural damage occurring without or before measurable atrophy.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_author" content="K. Morgen" />
<meta name="citation_author" content="G. Sammer" />
<meta name="citation_author" content="L. Weber" />
<meta name="citation_author" content="B. Aslan" />
<meta name="citation_author" content="C. Müller" />
<meta name="citation_author" content="G.F. Bachmann" />
<meta name="citation_author" content="D. Sandmann" />
<meta name="citation_author" content="M. Oechsner" />
<meta name="citation_author" content="D. Vaitl" />
<meta name="citation_author" content="M. Kaps" />
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<meta name="twitter:title" content="Structural Brain Abnormalities in Patients with Parkinson Disease: A Comparative Voxel-Based Analysis Using T1-Weighted MR Imaging and Magnetization Transfer Imaging" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: In PD, tissue damage occurs in specific cortical and subcortical regions. Conventional MR images have only limited capacity to depict these structural changes. The purpose of the current study was to investigate whether voxel-based MT imaging could indicate structural abnormalities beyond atrophy measurable with T1-weighted MR imaging.

MATERIALS AND METHODS: Thirty-six patients with PD without dementia (9 in H&amp;Y stage 1, thirteen in H&amp;Y 2, eleven in H&amp;Y 3, three in H&amp;Y 4) and 23 age-matched control subjects were studied with T1-weighted MR imaging and MT imaging. Voxel-based analyses of T1-weighted MR imaging was performed to investigate brain atrophy, while MT imaging was used to study abnormalities within existing tissue. Modulated GM and WM probability maps, sensitive to volume, and nonmodulated maps, indicative of tissue density, were obtained from T1-weighted MR imaging. Effects seen on MTR images, but absent on density maps, were attributed to damage of existing tissue.

RESULTS: Contrary to T1-weighted MR imaging, MT imaging was sensitive to the progression of brain pathology of the neocortex and paraventricular WM. MTR images and T1-based volume images, but not density images, showed a progression of disease in the olfactory cortex, indicating the occurrence of atrophy as well as damage to existing tissue in this region. MTR images revealed bilateral damage to the SN, while T1-weighted MR imaging only showed left-sided abnormalities.

CONCLUSIONS: The findings suggest that voxel-based MT imaging permits a whole-brain unbiased investigation of CNS structural integrity in PD and may be a valuable tool for identifying structural damage occurring without or before measurable atrophy.

### Abbreviations

FWHM
:   full width at half maximum
FWE
:   family-wise error
H&amp;Y
:   Hoehn and Yahr
GM
:   gray matter
ILF
:   inferior longitudinal fascicle
MMSE
:   Mini-Mental State Examination
MPRAGE
:   magnetization-prepared rapid acquisition of gradient echo
MT
:   magnetization transfer
MTR
:   magnetization transfer ratio
PD
:   Parkinson disease
SN
:   substantia nigra
SNc
:   substantia nigra, pars compacta
STG
:   superior temporal gyrus
UPDRS
:   United Parkinson Disease Rating Scale
VBM
:   voxel-based morphometry" />
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<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/early/2011/11/10/ajnr.A2837" />
<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: In PD, tissue damage occurs in specific cortical and subcortical regions. Conventional MR images have only limited capacity to depict these structural changes. The purpose of the current study was to investigate whether voxel-based MT imaging could indicate structural abnormalities beyond atrophy measurable with T1-weighted MR imaging.

MATERIALS AND METHODS: Thirty-six patients with PD without dementia (9 in H&amp;Y stage 1, thirteen in H&amp;Y 2, eleven in H&amp;Y 3, three in H&amp;Y 4) and 23 age-matched control subjects were studied with T1-weighted MR imaging and MT imaging. Voxel-based analyses of T1-weighted MR imaging was performed to investigate brain atrophy, while MT imaging was used to study abnormalities within existing tissue. Modulated GM and WM probability maps, sensitive to volume, and nonmodulated maps, indicative of tissue density, were obtained from T1-weighted MR imaging. Effects seen on MTR images, but absent on density maps, were attributed to damage of existing tissue.

RESULTS: Contrary to T1-weighted MR imaging, MT imaging was sensitive to the progression of brain pathology of the neocortex and paraventricular WM. MTR images and T1-based volume images, but not density images, showed a progression of disease in the olfactory cortex, indicating the occurrence of atrophy as well as damage to existing tissue in this region. MTR images revealed bilateral damage to the SN, while T1-weighted MR imaging only showed left-sided abnormalities.

CONCLUSIONS: The findings suggest that voxel-based MT imaging permits a whole-brain unbiased investigation of CNS structural integrity in PD and may be a valuable tool for identifying structural damage occurring without or before measurable atrophy.

### Abbreviations

FWHM
:   full width at half maximum
FWE
:   family-wise error
H&amp;Y
:   Hoehn and Yahr
GM
:   gray matter
ILF
:   inferior longitudinal fascicle
MMSE
:   Mini-Mental State Examination
MPRAGE
:   magnetization-prepared rapid acquisition of gradient echo
MT
:   magnetization transfer
MTR
:   magnetization transfer ratio
PD
:   Parkinson disease
SN
:   substantia nigra
SNc
:   substantia nigra, pars compacta
STG
:   superior temporal gyrus
UPDRS
:   United Parkinson Disease Rating Scale
VBM
:   voxel-based morphometry" />
<meta name="og-type" property="og:type" content="article" />
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">K. Morgen</span>, <span class="highwire-citation-author" data-delta="1">G. Sammer</span>, <span class="highwire-citation-author" data-delta="2">L. Weber</span>, <span class="highwire-citation-author" data-delta="3">B. Aslan</span>, <span class="highwire-citation-author" data-delta="4">C. Müller</span>, <span class="highwire-citation-author" data-delta="5">G.F. Bachmann</span>, <span class="highwire-citation-author" data-delta="6">D. Sandmann</span>, <span class="highwire-citation-author" data-delta="7">M. Oechsner</span>, <span class="highwire-citation-author" data-delta="8">D. Vaitl</span>, <span class="highwire-citation-author" data-delta="9">M. Kaps</span> and <span class="highwire-citation-author" data-delta="10">I. Reuter</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">November 2011,  </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A2837 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-49339--61194484999" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">K. Morgen </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=K.%2BMorgen%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=Morgen%20K&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 last"><a href="/search/author1%3AK.%2BMorgen%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">G. 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            <h2>Supplemental Online Tables</h2>
            <p><strong>Files in this Data Supplement:</strong></p>
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                  		<br/><br/>
                  <em>Online Table 1:</em>  Characteristics of patients and healthy control subjects
                  <br/><br/>
                  <em>Online Table 2:</em>  GM density, volume, and MTR:  group comparisons
                  <br/><br/>
                  <em>Online Table 3:</em>  Midbrain density, volume, and MTR:  group comparisons
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                  <em>Online Table 4:</em>  Tissue volume, density, and MTR:  correlations with UPDRS score in patient group
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