In:
Movement Disorders Clinical Practice, Wiley, Vol. 11, No. 4 ( 2024-04), p. 381-390
Abstract:
Advanced imaging techniques have been studied for differential diagnosis between PD, MSA, and PSP. Objectives This study aims to validate the utility of individual voxel‐based morphometry techniques for atypical parkinsonism in a blinded fashion. Methods Forty‐eight healthy controls (HC) T1‐WI were used to develop a referential dataset and fit a general linear model after segmentation into gray matter (GM) and white matter (WM) compartments. Segmented GM and WM with PD (n = 96), MSA (n = 18), and PSP (n = 20) were transformed into z ‐scores using the statistics of referential HC and individual voxel‐based z ‐score maps were generated. An imaging diagnosis was assigned by two independent raters (trained and untrained) blinded to clinical information and final diagnosis. Furthermore, we developed an observer‐independent index for ROI‐based automated differentiation. Results The diagnostic performance using voxel‐based z‐score maps by rater 1 and rater 2 for MSA yielded sensitivities: 0.89, 0.94 (95% CI: 0.74–1.00, 0.84–1.00), specificities: 0.94, 0.80 (0.90–0.98, 0.73–0.87); for PSP, sensitivities: 0.85, 0.90 (0.69–1.00, 0.77–1.00), specificities: 0.98, 0.94 (0.96–1.00, 0.90–0.98). Interrater agreement was good for MSA (Cohen's kappa: 0.61), and excellent for PSP (0.84). Receiver operating characteristic analysis using the ROI‐based new index showed an area under the curve (AUC): 0.89 (0.77–1.00) for MSA, and 0.99 (0.98–1.00) for PSP. Conclusions These evaluations provide support for the utility of this imaging technique in the differential diagnosis of atypical parkinsonism demonstrating a remarkably high differentiation accuracy for PSP, suggesting potential use in clinical settings in the future.
Type of Medium:
Online Resource
ISSN:
2330-1619
,
2330-1619
Language:
English
Publisher:
Wiley
Publication Date:
2024
detail.hit.zdb_id:
2772809-2
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