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European Radiology
Published in: European Radiology 2/2018

01-02-2018 | Magnetic Resonance

Clinical utility of visualisation of nigrosome-1 in patients with Parkinson’s disease

Authors: Albert Stezin, Rajini M. Naduthota, Ragasudha Botta, Shriram Varadharajan, Abhishek Lenka, Jitender Saini, Ravi Yadav, Pramod Kumar Pal

Published in: European Radiology | Issue 2/2018

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Abstract

Objective

To determine the diagnostic characteristics of poor visualisation of nigrosome-1 as a neuroimaging biomarker in Parkinson’s disease (PD) and to explore the relationship of poor visualisation of nigrosome-1 and clinical asymmetry.

Methods

High-resolution gradient-echo sequences of 67 patients with PD and 63 healthy controls were reviewed by two radiologists blinded to the clinical details. A three-tier classification system was used to categorise the scans based on the visualisation of nigrosome-1, and inter-rater reliability was calculated at each level of classification. Other diagnostic properties such as sensitivity, specificity and predictive values were calculated. The relationship between poor visualisation of nigrosome-1 and clinical asymmetry was also assessed.

Results

Poor visualisation of nigrosome-1 had high sensitivity (98.5%), specificity (93.6%), positive-predictive value (94.3%), negative-predictive value (98.3%), accuracy (96%) and inter-rater reliability (k = 0.75–0.92). Poorly visualised nigrosome-1 was significantly associated with higher motor asymmetry in the contralateral side in 64.8% of subjects (p = 0.004).

Conclusions

Poor visualisation of nigrosome-1 in PD had good diagnostic properties as a neuroimaging biomarker in PD. There was also a significant agreement on clinical asymmetry and poor visualisation of nigrosome-1.

Key Points

• Nigrosome-1 represents the largest collection of dopaminergic neurons in dorso-lateral substantia nigra.
• Loss of nigrosome-1 is being studied as a biomarker in Parkinson’s disease.
• Visualisation of nigrosome-1 had good diagnostic properties as a biomarker.
• There was a contralateral relationship between nigrosome-1 lateralisation and clinical asymmetry.
• We also highlight the potential limitations of nigrosome-1 visualisation as a biomarker.
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Metadata
Title
Clinical utility of visualisation of nigrosome-1 in patients with Parkinson’s disease
Authors
Albert Stezin
Rajini M. Naduthota
Ragasudha Botta
Shriram Varadharajan
Abhishek Lenka
Jitender Saini
Ravi Yadav
Pramod Kumar Pal
Publication date
01-02-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 2/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-4950-5

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