Changes of DTI scalars related to disease severity and cognitive impairment in PSP
Poster No:
2369
Submission Type:
Abstract Submission
Authors:
Silja Kannenberg1, Ann Carolin Hausmann2, Alfons Schnitzler3, Christian Hartmann4, Luisa Wolf5, Christian Rubbert6, Julian Caspers7
Institutions:
1Institute of Clinical Neuroscience &Medical Psychology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany, 2University Hospital Duesseldorf, Duesseldorf, Germany, 3Institute of Clinical Neuroscience & Medical Psychology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany, 4Department of Neurology, Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany, 5Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital, Duesseldorf, NRW, 6Medical Faculty and University Hospital Düsseldorf, Düsseldorf, NRW, 7Heinrich Heine University, Düsseldorf, Nordrhein-Westfalen
First Author:
Silja Kannenberg
Institute of Clinical Neuroscience &Medical Psychology, Medical Faculty, Heinrich-Heine-University
Duesseldorf, Germany
Institute of Clinical Neuroscience &Medical Psychology, Medical Faculty, Heinrich-Heine-University
Duesseldorf, Germany
Co-Author(s):
Alfons Schnitzler
Institute of Clinical Neuroscience & Medical Psychology, Medical Faculty, Heinrich-Heine-University
Duesseldorf, Germany
Institute of Clinical Neuroscience & Medical Psychology, Medical Faculty, Heinrich-Heine-University
Duesseldorf, Germany
Christian Hartmann
Department of Neurology, Medical Faculty, University Hospital Duesseldorf
Duesseldorf, Germany
Department of Neurology, Medical Faculty, University Hospital Duesseldorf
Duesseldorf, Germany
Luisa Wolf
Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital
Duesseldorf, NRW
Department of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital
Duesseldorf, NRW
Introduction:
Progressive supranuclear palsy (PSP) is a rapidly progressive neurodegenerative disorder accompanied with specific clinical symptoms, such as postural instability with backward falls and vertical gaze palsy. Though magnetic resonance imaging (MRI) markers have been identified, there is no consensus on broader white matter (WM) atrophy patterns. Understanding how WM degeneration could account for the disease-specific symptom complex and the underlying pathologies is crucial. We aimed to identify changes in diffusion tensor imaging (DTI) parameter changes of WM tracts related to cognitive performance and disease severity in PSP.
Methods:
15 patients (5 male; age: 70.07±7.03 years; disease duration: 14.07±14.24 months) with PSP-Richardson's syndrome completed the Montreal Cognitive Assessment (MoCA) and PSP Rating Scale (PSPRS). Multi-shell diffusion MRI (dMRI) was acquired and preprocessed on a 3T Siemens Prisma with a protocol according to the Human Connectome Project in Aging (HCP-A; 64 head coil, voxel-size 1.5mm³, 92 slices, FOV 210x210mm, TR=3200ms, TE=89ms, flip angle=90°, 185 gradient directions, b-values 0, 1500, 3000 s/mm²). Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) images were created using dtifit in FSL v. 6.0 and further processed with TBSS. Voxel-wise analyses were applied on the skeletonized FA, MD, AD, and RD data for correlations with MoCA and PSPRS sum score using general linear models and permutation testing (5000 permutations) controlling for multiple comparisons and applying Threshold-Free Cluster Enhancement (TFCE; p≤0.05, FWE-corrected). Significant clusters were located and labelled anatomically to the Johns Hopkins University WM tractography atlas.
Results:
We found clusters of reduced FA values correlated with increased PSPRS sum score (M=36.07±9.07) in the following WM tracts: corpus callosum (genu and body); bilateral superior, middle and inferior cerebellar peduncle; bilateral corticospinal tracts; bilateral medial lemniscus; bilateral anterior thalamic radiation (p=.028). The PSPRS gait sub score correlated highly with the mentioned WM tracts (p<.001). Complementing this, we found significant positive correlations between MD and RD and PSPRS scores in: bilateral anterior and posterior thalamic radiation; bilateral corticospinal tract; corpus callosum (genu;body;splenium); bilateral inferior and superior cerebellar peduncle; posterior corona radiata; bilateral superior longitudinal fasciculus (Fig. 1).FA and AD values exhibited significant positive correlations with MoCA scores (M=19.62±4.50) in the following WM tracts: bilateral middle cerebellar peduncle; external capsule; bilateral optic radiation; bilateral superior longitudinal fasciculus; bilateral anterior and posterior corona radiata; bilateral inferior fronto-occipital fasciculus; left internal capsule; forceps minor and major. Further, we found significant negative correlations of RD and MoCA in: bilateral anterior thalamic radiation; bilateral corticospinal tract; corpus callosum (genu;body;splenium); bilateral inferior fronto-occipital fasciculus; bilateral superior longitudinal fasciculus (Fig. 2).
·Fig. 1 TBSS results showing voxels where an increase in PSPRS score was significantly correlated with FA decrease (red-yellow) as well as MD increase (blue) and RD increase (blue).
·TBSS results showing voxels where a decrease in MoCA score was significantly correlated with FA decrease (red-yellow) as well as AD decrease (black) and RD increase (blue).
Conclusions:
We revealed areas of significant WM tract degeneration related to markers of cognitive dysfunction and disease severity in PSP; reduced FA values complemented by increased MD and RD values observed in motor-related WM tracts incl. the corticospinal tract, corpus callosum and cerebellar peduncles are probably related to specific motor symptoms of the disease such as unbalanced gait and postural instability. FA decrease in the superior longitudinal fasciculus can be linked to cognitive decline through frontoparietal decoupling, especially regarding impairment of visuospatial abilities. As PSP might be a more network-based disorder, the present work confirms that considering disease-specific WM atrophy patterns might provide a better understanding of the complex symptom-characteristics of PSP.
Disorders of the Nervous System:
Neurodegenerative/ Late Life (eg. Parkinson’s, Alzheimer’s) 2
Modeling and Analysis Methods:
Diffusion MRI Modeling and Analysis
Novel Imaging Acquisition Methods:
Diffusion MRI 1
Keywords:
MRI
WHITE MATTER IMAGING - DTI, HARDI, DSI, ETC
Other - Progressive Supranuclear Palsy
1|2Indicates the priority used for review
Provide references using author date format
Minn HCP Consortium. (2013). The minimal preprocessing pipelines for the Human
Connectome Project. Neuroimage, 80, 105-124.
Höglinger, G. U., Respondek, G., Stamelou, M., Kurz, C., Josephs, K. A., Lang, A. E., ... & Bordelon,
Y. (2017). Clinical diagnosis of progressive supranuclear palsy: the movement disorder society
criteria. Movement Disorders, 32(6), 853-864.
Koshiyama, D., Fukunaga, M., Okada, N., Morita, K., Nemoto, K., Yamashita, F., ... & Hashimoto, R.
(2020). Association between the superior longitudinal fasciculus and perceptual organization
and working memory: a diffusion tensor imaging study. Neuroscience Letters, 738, 135349.
Massey, L. A., Jäger, H. R., Paviour, D. C., O’Sullivan, S. S., Ling, H., Williams, D. R., ... & Micallef,
C. (2013). The midbrain to pons ratio: a simple and specific MRI sign of progressive
supranuclear palsy. Neurology, 80(20), 1856-1861.
Potrusil, T., Krismer, F., Beliveau, V., Seppi, K., Müller, C., Troger, F., ... & Scherfler, C. (2020).
Diagnostic potential of automated tractography in progressive supranuclear palsy variants.
Parkinsonism & Related Disorders, 72, 65-71.
Prasad, S., Rajan, A., Pasha, S. A., Mangalore, S., Saini, J., Ingalhalikar, M., & Pal, P. K. (2021).
Abnormal structural connectivity in progressive supranuclear palsy—Richardson syndrome.
Acta Neurologica Scandinavica, 143(4), 430-440.
Quattrone, A., Morelli, M., Nigro, S., Quattrone, A., Vescio, B., Arabia, G., ... & Caracciolo, M. (2018).
A new MR imaging index for differentiation of progressive supranuclear palsy-parkinsonism
from Parkinson's disease. Parkinsonism & related disorders, 54, 3-8.
Sintini, I., Kaufman, K., Botha, H., Martin, P. R., Loushin, S. R., Senjem, M. L., ... & Ali, F. (2021).
Neuroimaging correlates of gait abnormalities in progressive supranuclear palsy. NeuroImage:
Clinical, 32, 102850.
Whitwell, J. L., Master, A. V., Avula, R., Kantarci, K., Eggers, S. D., Edmonson, H. A., ... & Josephs,
K. A. (2011). Clinical correlates of white matter tract degeneration in progressive supranuclear
palsy. Archives of neurology, 68(6), 753-760.
Worker, A., Blain, C., Jarosz, J., Chaudhuri, K. R., Barker, G. J., Williams, S. C., ... & Simmons, A.
(2014). Diffusion tensor imaging of Parkinson’s disease, multiple system atrophy and
progressive s