RT Journal Article
SR Electronic
T1 Neuroimaging Correlates with Clinical Severity in Wilson Disease: A Multiparametric Quantitative Brain MRI
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
DO 10.3174/ajnr.A8479
A1 Jing, Xiao-Zhong
A1 Li, Gai-Ying
A1 Wu, Yu-Peng
A1 Yuan, Xiang-Zhen
A1 Chen, Jia-Lin
A1 Wang, Shu-Hong
A1 Wang, Xiao-Ping
A1 Li, Jian-Qi
YR 2024
UL http://www.ajnr.org/content/early/2024/10/17/ajnr.A8479.abstract
AB BACKGROUND AND PURPOSE: Previous studies have reported metal accumulation and microstructure changes in deep gray nuclei (DGN) in Wilson disease (WD). However, there are limited studies that investigate whether there is metal accumulation and microstructure changes in DGN of patients with WD with normal-appearing routine MRI. This study aimed to evaluate multiparametric changes in DGN of WD and whether the findings correlate with clinical severity in patients with WD.MATERIALS AND METHODS: The study enrolled 28 patients with WD (19 with neurologic symptoms) and 25 controls. Fractional anisotropy (FA), mean diffusivity (MD), and magnetic susceptibility in globus pallidus, pontine tegmentum, dentate nucleus, red nucleus, head of caudate nucleus, putamen, substantia nigra, and thalamus were extracted. Correlations between imaging data and the Unified Wilson’s Disease Rating Scale (UWDRS) neurologic subitems were explored.RESULTS: FA, MD, and susceptibility values were higher in multiple DGN of patients with WD than controls (P < .05). Patients with WD without abnormal signals in DGN on routine MRI also had higher FA, MD, and susceptibility values than controls (P < .017). We found that UWDRS neurologic subscores correlated with FA and susceptibility values of DGN (P < .05). In addition, we also found that FA and susceptibility values in specific structures correlated with specific neurologic symptoms of WD (ie, tremor, parkinsonism, dysarthria, dystonia, and ataxia) (P < .05).CONCLUSIONS: Patients with WD have increased FA, MD, and susceptibility values even before the lesion is morphologically apparent on routine MRI. The increased FA and susceptibility values correlate with clinical severity of WD.CNhead of the caudate nucleusDGNdeep gray nucleiDNdentate nucleusFAfractional anisotropyGPglobus pallidusGREgradient echoICCintraclass correlation coefficientMDmean diffusivityPTpontine tegmentumPutputamenQSMquantitative susceptibility mappingRNred nucleusSNsubstantia nigraTHthalamusUWDRSUnified Wilson’s Disease Rating ScaleWDWilson disease