Differential diagnosis of tremor syndromes using MRI relaxometry

Pavel Filip, Lubomír Vojtíšek, Marek Baláž, Silvia Mangia, Shalom Michaeli, Rastislav Šumec, Martin Bareš

Research output: Contribution to journalArticlepeer-review

Abstract

Differential diagnosis of the most common tremor syndromes – essential tremor (ET) and Parkinson's disease (PD) is burdened with high error rate. However, diagnostic MRI biomarkers applicable in this clinically highly relevant scenario remain an unfulfilled objective. The presented study was designed in search for possible candidate MRI protocols relevant for differential diagnostic process in tremor syndromes.10 non-advanced tremor-dominant PD patients meeting diagnostic criteria for clinically established PD, 12 isolated ET patients and 16 healthy controls were enrolled into this study. The study focused on relaxation MRI protocols – T1, T2, adiabatic T1ρ and adiabatic T2ρ due to their relatively low post-processing requirements enabling implementation into routine clinical practice. Compared to ET, PD patients had significantly longer T2 relaxation times in striata with dominant findings in the putamen contralateral to the clinically more affected body side. This difference was driven by alterations in the PD group as confirmed in the complementary comparison with healthy controls. According to the receiver operating characteristic analysis, this region provided a reasonable sensitivity of 0.91 and specificity of 0.89 in the differential diagnosis of PD and ET. In PD patients, we further found prolonged T1ρ in the substantia nigra compared to ET and healthy controls, and shorter T2 and T2ρ in the cerebellum compared to healthy controls. T2 relaxation time in the putamen contralateral to the clinically more affected body side is a plausible candidate diagnostic marker for the differentiation of PD and ET.

Original languageEnglish (US)
Pages (from-to)190-193
Number of pages4
JournalParkinsonism and Related Disorders
Volume81
DOIs
StatePublished - Dec 2020
Externally publishedYes

Bibliographical note

Funding Information:
Support was provided by the European Union's Horizon 2020 research and innovation program under the Marie Skłodowska-Curie grant agreement No 691110 (MICROBRADAM).

Funding Information:
Support was provided by the European Union's Horizon 2020 research and innovation program under the Marie Skłodowska-Curie grant agreement No 691110 (MICROBRADAM) . We acknowledge the core facility MAFIL of CEITEC supported by the MEYS CR ( LM2018129 Czech-BioImaging ).

Funding Information:
The authors with to express their sincere thanks to the patients and their families for their support of research activities. Support was provided by the European Union's Horizon 2020 research and innovation program under the Marie Sk?odowska-Curie grant agreement No 691110 (MICROBRADAM). We acknowledge the core facility MAFIL of CEITEC supported by the MEYS CR (LM2018129 Czech-BioImaging).

Publisher Copyright:
© 2020

Keywords

  • Adiabatic T1ρ and T2ρ mapping
  • Essential tremor
  • Parkinson's disease
  • T1 and T2 mapping
  • Tremor

PubMed: MeSH publication types

  • Journal Article
  • Research Support, Non-U.S. Gov't

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