Neurology 71(9):670–676įujiwara S, Sasaki M, Kanbara Y, Inoue T, Hirooka R, Ogawa A (2008) Feasibility of 1.6-mm isotropic voxel diffusion tensor tractography in depicting limbic fibers. Gilman S, Wenning GK, Low PA, Brooks DJ, Mathias CJ, Trojanowski JQ et al (2008) Second consensus statement on the diagnosis of multiple system atrophy. Prakash N, Hageman N, Hua X, Toga AW, Perlman SL, Salamon N (2009) Patterns of fractional anisotropy changes in white matter of cerebellar peduncles distinguish spinocerebellar ataxia-1 from multiple system atrophy and other ataxia syndromes. J Neurol Neurosurg Psychiatry 78(7):722–728 Ito M, Watanabe H, Kawai Y, Atsuta N, Tanaka F, Naganawa S et al (2007) Usefulness of combined fractional anisotropy and apparent diffusion coefficient values for detection of involvement in multiple system atrophy. Nagesh V, Tsien CI, Chenevert TL, Ross BD, Lawrence TS, Junick L et al (2008) Radiation-induced changes in normal-appearing white matter in patients with cerebral tumors: a diffusion tensor imaging study. Marek M, Paus S, Allert N, Madler B, Klockgether T, Urbach H et al (2015) Ataxia and tremor due to lesions involving cerebellar projection pathways: a DTI tractographic study in six patients. Radiology 255(2):563–569įoerster BR, Carlos RC, Dwamena BA, Callaghan BC, Petrou M, Edden RA et al (2014) Multimodal MRI as a diagnostic biomarker for amyotrophic lateral sclerosis. Tha KK, Terae S, Yabe I, Miyamoto T, Soma H, Zaitsu Y et al (2010) Microstructural white matter abnormalities of multiple system atrophy: in vivo topographic illustration by using diffusion-tensor MR imaging. J Neurol Sci 71(2–3):193–208īaloh RW, Yee RD, Honrubia V (1986) Late cortical cerebellar atrophy. Kanazawa I, Kwak S, Sasaki H, Mizusawa H, Muramoto O, Yoshizawa K et al (1985) Studies on neurotransmitter markers and neuronal cell density in the cerebellar system in olivopontocerebellar atrophy and cortical cerebellar atrophy. Klockgether T (2012) Sporadic adult-onset ataxia of unknown etiology. J Neurol Neurosurg Psychiatry 65(1):65–71Ībele M, Burk K, Schols L, Schwartz S, Besenthal I, Dichgans J et al (2002) The aetiology of sporadic adult-onset ataxia. Schrag A, Kingsley D, Phatouros C, Mathias CJ, Lees AJ, Daniel SE et al (1998) Clinical usefulness of magnetic resonance imaging in multiple system atrophy. Wakabayashi K, Takahashi H (2006) Cellular pathology in multiple system atrophy. Tsuji S, Onodera O, Goto J, Nishizawa M, Study Group on Ataxic D (2008) Sporadic ataxias in Japan–a population-based epidemiological study. Gilman S, Low PA, Quinn N, Albanese A, Ben-Shlomo Y, Fowler CJ et al (1999) Consensus statement on the diagnosis of multiple system atrophy. When combining the FA values of efferent 1 with disease duration, the present DTI tractography analysis could be useful for differentiating MSA-C and CCA patients. The present DTI tractography newly showed that the FA values of two afferent fiber tracts showed significant declines in MSA-C patients, and afferent 1 showed good diagnostic sensitivity and specificity. Linear regressions showed strong correlations between FA value and disease duration in CCA patients (efferent 1, r = −0.466 afferent 2, r = −0.543 both p < 0.05), and between the FA value and the ratio of the standardized scale for the assessment and rating of ataxia (SARA)/disease duration in MSA-C patients (afferent 1, r = −0.407 p < 0.01). Receiver-operator characteristic curve analysis showed 85.7 % sensitivity and 75.0 % specificity of FA values in afferent 1 (cutoff value 0.476). Compared with CCA, MSA-C patients showed significant declines of fractional anisotropy (FA) values of afferent 1 and 2 ( p < 0.01, respectively) and a significant increase of the radial diffusivity (RD) value in afferent 1 ( p < 0.05). Tractography was performed using the DTI track module provided in the MedINRIA version 1.9.4, and regions of interest were drawn manually to reconstruct an efferent fiber tract and two afferent fiber tracts via the cerebellum. Forty-one MSA-C patients (62.7 ± 8.1 years old, mean ± SD) and age- and gender-matched 15 CCA patients (63.0 ± 8.6 years old) were examined. The objective of this study is to determine whether diffusion tensor imaging (DTI) tractography analysis is a potential method for differentiating cerebellar ataxia patients with multiple system atrophy with predominant cerebellar ataxia (MSA-C) and cortical cerebellar atrophy (CCA).
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