Direct visualization of Parkinson's disease by in vivo human brain imaging using 7.0T magnetic resonance imaging.
ABSTRACT Parkinson's disease (PD) is a neurodegenerative disorder resulting from progressive loss of dopaminergic neurons in the substantia nigra (SN) pars compacta. Therefore, imaging of the SN has been regarded to hold greatest potential for use in the diagnosis of PD. At the 7.0T magnetic resonance imaging (MRI), it is now possible to delineate clearly the shapes and boundaries of the SN. We scanned eight early and two advanced PD patients, along with nine age-matched control subjects, using a 7.0T MRI in an attempt to directly visualize the SN and quantify the differences in shape and boundaries of SN between PD subjects in comparison with the normal control subjects. In the normal controls, the boundaries between the SN and crus cerebri appear smooth, and clean "arch" shapes that stretch ventrally from posterior to anterior. In contrast, these smooth and clean arch-like boundaries were lost in PD subjects. The measured correlation analyses show that, in PD patients, there is age-dependent correlation and substantially stronger UPDRS motor score-dependent correlation. These results suggest that, by using 7.0T MRI, it appears possible to use these visible and distinctive changes in morphology as a diagnostic marker of PD.
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ABSTRACT: It could be shown that the post mortem analysis of biogenic amines, precursors and metabolites in the human brain are influenced by various parameters. 1. The patient's medical history; long term observations of the course of the disease; age; sex. 2. Terminal illness; duration of terminal illness. 3. Previous treatment with drugs; last drugs. 4. Time interval between last drug treatment and death; time of day and date of last drug consumption. 5. Rapidity of death; time of death; duration of coma. 6. Changes occurring in tissues before death; patients' constitution during terminal illness. 7. Changes in concentration of the biogenic amines, precursors, and metabolites depending on the patient's age. 8. Time between death and necropsy. 9 Dissection of specimen. 10. Period of storage; temperature of storage. 11. Chronbiological rhythm of substances. 12. Methods of assayL 13. Homogeneity of all mentioned parameters in the control group and patient's group. For the first time it could be demonstrated that the time course of nigrostriatal degeneration, independent of the age of the parkinsonian at the beginning of the illness, is linear for the last stage and the denervation progressively increases as the duration of illness progresses.Journal of Neural Transmission 02/1976; 38(3-4):277-301. · 3.05 Impact Factor
- New England Journal of Medicine 11/1998; 339(15):1044-53. · 51.66 Impact Factor
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ABSTRACT: Although it is important to evaluate the substantia nigra in patients with parkinsonian syndrome, it is difficult to depict its anatomy, even by MR imaging. Using anatomic studies of the direction of nerve fibers around the substantia nigra, we attempted to depict this entity with multishot diffusion-weighted MR imaging to evaluate its topographic changes in patients with Parkinson's disease and secondary parkinsonism. We measured the substantia nigra on 72 diffusion-weighted axial MR images obtained in 36 healthy control subjects, on 47 images obtained in 25 patients with Parkinson's disease, and on 10 images obtained in five patients with secondary parkinsonism. We considered the width of the minor axis of the substantia nigra as its "thickness," which appeared as a crescent-shaped region in the midbrain. Diffusion-weighted imaging portrayed the substantia nigra distinctly better than did T2-weighted imaging, because the surrounding white matter appeared as an area of high signal intensity. The mean (+/- SD) thickness values of the substantia nigra were 5.1+/-0.89 mm in control subjects, 4.8+/-0.75 mm in patients with Parkinson's disease, and 3.4+/-0.53 mm in patients with secondary parkinsonism. Multishot diffusion-weighted imaging is a better imaging technique than T2-weighted imaging for demonstrating a change in size of the substantia nigra in vivo. The substantia nigra is not reduced in size in patients with Parkinson's disease, but it is reduced in patients with secondary parkinsonism.American Journal of Neuroradiology 10/1999; 20(8):1500-6. · 3.17 Impact Factor