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01-06-2017 | Neuro

Substantia nigra fractional anisotropy is not a diagnostic biomarker of Parkinson’s disease: A diagnostic performance study and meta-analysis

Authors: Fabiana C. C. Hirata, João R. Sato, Gilson Vieira, Leandro T. Lucato, Claudia C. Leite, Edson Bor-Seng-Shu, Bruno F. Pastorello, Maria C. G. Otaduy, Khallil T. Chaim, Kenia R. Campanholo, Natalia P. Novaes, Luciano Magalhães Melo, Márcia R. Gonçalves, Felipe Barjud Pereira do Nascimento, Manoel Jacobsen Teixeira, Egberto Reis Barbosa, Edson Amaro Jr, Ellison Fernando Cardoso

Published in: European Radiology | Issue 6/2017

Abstract

Objectives

Our goal was to estimate the diagnostic accuracy of substantia nigra fractional anisotropy (SN-FA) for Parkinson’s disease (PD) diagnosis in a sample similar to the clinical setting, including patients with essential tremor (ET) and healthy controls (HC). We also performed a systematic review and meta-analysis to estimate mean change in SN-FA induced by PD and its diagnostic accuracy.

Methods

Our sample consisted of 135 subjects: 72 PD, 21 ET and 42 HC. To address inter-scanner variability, two 3.0-T MRI scans were performed. MRI results of this sample were pooled into a meta-analysis that included 1,432 subjects (806 PD and 626 HC). A bivariate model was used to evaluate diagnostic accuracy measures.

Results

In our sample, we did not observe a significant effect of disease on SN-FA and it was uninformative for diagnosis. The results of the meta-analysis estimated a 0.03 decrease in mean SN-FA in PD relative to HC (CI: 0.01–0.05). However, the discriminatory capability of SN-FA to diagnose PD was low: pooled sensitivity and specificity were 72 % (CI: 68–75) and 63 % (CI: 58–70), respectively. There was high heterogeneity between studies (I² = 91.9 %).

Conclusions

SN-FA cannot be used as an isolated measure to diagnose PD.

Key Points

• SN-FA appears insufficiently sensitive and specific to diagnose PD.

• Radiologists must be careful when translating mean group results to clinical practice.

• Imaging protocol and analysis standardization is necessary for developing reproducible quantitative biomarkers.

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Title: Substantia nigra fractional anisotropy is not a diagnostic biomarker of Parkinson’s disease: A diagnostic performance study and meta-analysis
Authors: Fabiana C. C. Hirata
João R. Sato
Gilson Vieira
Leandro T. Lucato
Claudia C. Leite
Edson Bor-Seng-Shu
Bruno F. Pastorello
Maria C. G. Otaduy
Khallil T. Chaim
Kenia R. Campanholo
Natalia P. Novaes
Luciano Magalhães Melo
Márcia R. Gonçalves
Felipe Barjud Pereira do Nascimento
Manoel Jacobsen Teixeira
Egberto Reis Barbosa
Edson Amaro Jr
Ellison Fernando Cardoso
Publication date: 01-06-2017
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 6/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-016-4611-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Substantia nigra fractional anisotropy is not a diagnostic biomarker of Parkinson’s disease: A diagnostic performance study and meta-analysis

Abstract

Objectives

Methods

Results

Conclusions

Key Points

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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