RT Journal Article
SR Electronic
T1 Fractional Anisotropy is a More Sensitive Diagnostic Biomarker Than Mean Kurtosis for Patients with Parkinson Disease with Cognitive Dysfunction: A Diffusional Kurtosis Map Tract-Based Spatial Statistics Study
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1098
OP 1105
DO 10.3174/ajnr.A8297
VO 45
IS 8
A1 Gao, Bingbing
A1 Qu, Mingrui
A1 Jiang, Yuhan
A1 Li, Wanyao
A1 Wang, Man
A1 Pei, Chenhui
A1 Zheng, Dandan
A1 Yang, Chao
A1 Miao, Yanwei
YR 2024
UL http://www.ajnr.org/content/45/8/1098.abstract
AB BACKGROUND AND PURPOSE: There is heterogeneity of white matter damage in Parkinson's disease patients with different cognitive states. Our aim was to find sensitive diffusional kurtosis imaging biomarkers to differentiate the white matter damage pattern of mild cognitive impairment and dementia.MATERIALS AND METHODS: Nineteen patients with Parkinson disease with mild cognitive impairment and 18 patients with Parkinson disease with dementia were prospectively enrolled. All participants underwent MR examination with 3D-T1-weighted image and diffusional kurtosis imaging sequences. Demographic data were compared between the 2 groups. Voxelwise statistical analyses of diffusional kurtosis imaging parameters were performed using tract-based spatial statistics. The receiver operator characteristic curve of significantly different metrics was graphed. The correlation of significantly different metrics with global cognitive status was analyzed.RESULTS: Compared with the Parkinson disease with mild cognitive impairment group, the fractional anisotropy and mean kurtosis values decreased in 4 independent clusters in the forceps minor, forceps major, inferior fronto-occipital fasciculus, and the inferior and superior longitudinal fasciculus in patients with Parkinson disease with dementia; the mean diffusivity decreased in 1 cluster in the forceps minor. The fractional anisotropy value in the inferior fronto-occipital fasciculus and inferior longitudinal fasciculus would be the diffusional kurtosis imaging marker for the differential diagnosis of Parkinson disease with mild cognitive impairment and patients with Parkinson disease with dementia, with the best diagnostic efficiency of 0.853. The fractional anisotropy values in the forceps minor (β = 84.20, P < .001) and years of education (β = 0.38, P = .014) were positively correlated with the Montreal Cognitive Assessment.CONCLUSIONS: The diffusional kurtosis imaging–derived fractional anisotropy and mean kurtosis can detect the different white matter damage patterns of Parkinson disease with mild cognitive impairment and Parkinson disease with dementia. Fractional anisotropy is more sensitive than mean kurtosis in the differential diagnosis; fractional anisotropy derived from diffusional kurtosis imaging could become a promising imaging marker for the differential diagnosis of Parkinson disease with mild cognitive impairment and Parkinson disease with dementia.AUCarea under the curveDKIdiffusional kurtosis imagingFAfractional anisotropyH-Y stageHoehn-Yahr stageJHUJohns Hopkins UniversityMDmean diffusivityMKmean kurtosisMMSEMini-Mental State ExaminationMoCAMontreal Cognitive AssessmentPDParkinson diseasePD-MCIParkinson disease with mild cognitive impairmentPDDParkinson disease with dementiaROCreceiver operating characteristicTFCEthreshold-free cluster enhancement