Patients with Progressive Supranuclear Palsy Evaluated Using Diffusion Tensor Magnetic Resonance Imaging in a High Field Scanner

The project proposed to assess white matter integrity in patients with Progressive Supranuclear Palsy evaluated by diffusion tensor magnetic resonance imaging. Progressive supranuclear palsy is the second most common neurodegenerative extrapyramidal disorder after Parkinson Disease. It is a rapidly progressing degenerative disease of unknown origin. Clinically to differentiate progressive supranuclear palsy from other Parkinsonian disorders can be challenging, especially in the early stages of the disease. Conventional MR images from patients with progressive supranuclear palsy showed severe atrophy in the brain stem area at an advanced stage. In degenerative diseases, functional impairment and neuronal loss can lead to changes in the principal fibre connecting tracts, which can then be detected by Diffusion Tensor Imaging. The increased sensitivity of diffusion tensor imaging in demonstrating white matter pathology has been shown in several neurological diseases and noticeably in our pilot study. A degeneration of anatomically and functionally connected grey matter structures in patients with progressive supranuclear palsy was noticed in previous studies. Changes in anisotropic diffusion, as measured from patients with progressive supranuclear palsy in the preliminary result, might suggest that white matter pathology could be an early marker of the disease, beyond the involvement of grey matter structures. In the current study, it was proposed to characterize the brain changes by diffusion tensor imaging in the early phase of progressive supranuclear palsy as distinguished from other Parkinsonian disorders in longitudinal study of three consecutive years. The sensitivity, specificity, false positive detection rate and false negative detection rate will be examined. White matter tractography will be performed to assess the integrity of neuron fibers. Clinical evaluation will be correlated with the image finding as the diseases progresses from an early to an advanced stage. The images will be normalized to a local template. A functional connectivity map will be reconstructed and compared with the result from tractography. The primary goal of the project is to assess the capability of diffusion tensor imaging as an early detection tool for the disease. Secondly it is to evaluate the microstructural changes in white matter fiber tracts as the disease progresses. Clinical symptoms will be correlated with the neuroimage findings. Finally it is to investigate the potential of diffusion anisotropy in providing differential diagnosis criteria, from other Parkinsonian disorders.

Project ID:PC9902-1669
External Project ID:NSC98-2314-B182-036-MY2