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Microstructural changes of normal-appearing white matter in Vascular Parkinsonism

M. Salsone, ME. Caligiuri, V. Vescio, G. Arabia, A. Cherubini, G. Nicoletti, M. Morelli, A. Quattrone, B. Vescio, R. Nisticò, F. Novellino, GL. Cascini, U. Sabatini, M. Montilla, I. Rektor, A. Quattrone,

. 2019 ; 63 (-) : 60-65. [pub] 20190301

Language English Country Great Britain

Document type Journal Article

Persistent link   https://www.medvik.cz/link/bmc20023923

OBJECTIVE: Several evidences demonstrated the role of white matter (WM) lesions in the pathogenesis of Vascular Parkinsonism (VP), a clinical entity characterized by parkinsonism, postural instability, marked gait difficulty and poor response to levodopa. However, the involvement of normal appearing white matter (NAWM) in VP still remains unknown. This study aimed to investigate the microstructural integrity of NAWM in VP compared to Parkinson's disease (PD) and controls using neuroimaging approach. METHODS: Magnetic resonance imaging data were acquired from 50 participants (15 VP, 20 PD and 15 controls). Diffusion tensor imaging (DTI) and Tract-based spatial statistics (TBSS) were performed to assess microstructural NAWM changes. In order to evaluate the relationship between specific fiber tract involvement and clinical picture, diffusion alterations were correlated with clinical features. RESULTS: Compared to PD patients and controls, significantly reduced fractional anisotropy (FA) and increased mean diffusivity (MD) and radial diffusivity (RD) in NAWM of corpus callosum, internal and external capsule, and corona radiata were present in VP. By contrast, DTI metrics were normal in NAWM-PD and controls. A significant correlation was found between FA and MD of anterior third of corpus callosum and clinical variables (postural instability, freezing-of-gait and symmetry of parkinsonism). CONCLUSIONS: This study improves the knowledge on WM pathology in VP, as our results demonstrate that NAWM damage occurs in VP, but not in PD nor in controls. NAWM damage might relate to clinical picture and suggest that non-clearly-visible WM alterations may contribute to the physiopathology of this vascular disease.

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$a OBJECTIVE: Several evidences demonstrated the role of white matter (WM) lesions in the pathogenesis of Vascular Parkinsonism (VP), a clinical entity characterized by parkinsonism, postural instability, marked gait difficulty and poor response to levodopa. However, the involvement of normal appearing white matter (NAWM) in VP still remains unknown. This study aimed to investigate the microstructural integrity of NAWM in VP compared to Parkinson's disease (PD) and controls using neuroimaging approach. METHODS: Magnetic resonance imaging data were acquired from 50 participants (15 VP, 20 PD and 15 controls). Diffusion tensor imaging (DTI) and Tract-based spatial statistics (TBSS) were performed to assess microstructural NAWM changes. In order to evaluate the relationship between specific fiber tract involvement and clinical picture, diffusion alterations were correlated with clinical features. RESULTS: Compared to PD patients and controls, significantly reduced fractional anisotropy (FA) and increased mean diffusivity (MD) and radial diffusivity (RD) in NAWM of corpus callosum, internal and external capsule, and corona radiata were present in VP. By contrast, DTI metrics were normal in NAWM-PD and controls. A significant correlation was found between FA and MD of anterior third of corpus callosum and clinical variables (postural instability, freezing-of-gait and symmetry of parkinsonism). CONCLUSIONS: This study improves the knowledge on WM pathology in VP, as our results demonstrate that NAWM damage occurs in VP, but not in PD nor in controls. NAWM damage might relate to clinical picture and suggest that non-clearly-visible WM alterations may contribute to the physiopathology of this vascular disease.
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$a Caligiuri, Maria Eugenia $u Neuroscience Center, University "Magna Graecia", Catanzaro, Italy.
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$a Arabia, Gennarina $u Institute of Neurology, University "Magna Graecia", Catanzaro, Italy.
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$a Cherubini, Andrea $u Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy.
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$a Morelli, Maurizio $u Institute of Neurology, University "Magna Graecia", Catanzaro, Italy.
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$a Quattrone, Andrea $u Institute of Neurology, University "Magna Graecia", Catanzaro, Italy.
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$a Nisticò, Rita $u Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy.
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$a Novellino, Fabiana $u Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy.
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$a Cascini, Giuseppe Lucio $u Nuclear Medicine Unit, University "Magna Graecia", Catanzaro, Italy.
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$a Montilla, Michaela $u Masaryk University, Central European Institute of Technology - CEITEC, Neuroscience Centre and Movement Disorders Centre, Brno, Czech Republic.
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$a Rektor, Ivan $u Masaryk University, Central European Institute of Technology - CEITEC, Neuroscience Centre and Movement Disorders Centre, Brno, Czech Republic.
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