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Open Access 01-12-2020 | Magnetic Resonance Imaging | Research article

A distinct neuromelanin magnetic resonance imaging pattern in parkinsonian multiple system atrophy

Authors: Rita Moiron Simões, Ana Castro Caldas, Joana Grilo, Daisy Correia, Carla Guerreiro, Patrícia Pita Lobo, Anabela Valadas, Marguerita Fabbri, Leonor Correia Guedes, Miguel Coelho, Mario Miguel Rosa, Joaquim J. Ferreira, Sofia Reimão

Published in: BMC Neurology | Issue 1/2020

Abstract

Background

Parkinsonian variant of multiple system atrophy is a neurodegenerative disorder frequently misdiagnosed as Parkinson’s disease. No early imaging biomarkers currently differentiate these disorders.

Methods

Simple visual imaging analysis of the substantia nigra and locus coeruleus in neuromelanin-sensitive magnetic resonance imaging and nigrosome 1 in susceptibility-weighted sequences was performed in thirty patients with parkinsonian variant of multiple system atrophy fulfilling possible/probable second consensus diagnostic criteria. The neuromelanin visual pattern was compared to patients with Parkinson’s disease with the same disease duration (n = 10) and healthy controls (n = 10). Substantia nigra semi-automated neuromelanin area/signal intensity was compared to the visual data.

Results

Groups were similar in age, sex, disease duration, and levodopa equivalent dose. Hoehn & Yahr stage was higher in parkinsonian multiple system atrophy patients, 69% of whom had normal neuromelanin size/signal, significantly different from Parkinson’s disease patients, and similar to controls. Nigrosome 1 signal was lost in 74% of parkinsonian multiple system atrophy patients. Semi-automated neuromelanin substantia nigra signal, but not area, measurements were able to differentiate groups.

Conclusions

In patients with parkinsonism, simple visual magnetic resonance imaging analysis showing normal neuromelanin substantia nigra and locus coeruleus, combined with nigrosome 1 loss, allowed the distinction of the parkinsonian variant of multiple system atrophy from Parkinson’s disease and healthy controls. This easy and widely available method was superior to semi-automated measurements in identifying specific imaging changes in substantia nigra and locus coeruleus.

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Title: A distinct neuromelanin magnetic resonance imaging pattern in parkinsonian multiple system atrophy
Authors: Rita Moiron Simões
Ana Castro Caldas
Joana Grilo
Daisy Correia
Carla Guerreiro
Patrícia Pita Lobo
Anabela Valadas
Marguerita Fabbri
Leonor Correia Guedes
Miguel Coelho
Mario Miguel Rosa
Joaquim J. Ferreira
Sofia Reimão
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Parkinson's Disease
Published in: BMC Neurology / Issue 1/2020
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/s12883-020-02007-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A distinct neuromelanin magnetic resonance imaging pattern in parkinsonian multiple system atrophy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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