The ‘Swallow Tail’ Appearance of the Healthy Nigrosome – A New Accurate Test of Parkinson's Disease: A Case-Control and Retrospective Cross-Sectional MRI Study at 3T

Schwarz, Stefan; Afzal, Mohammed; Morgan, Paul; Auer, Dorothee; Bajaj, Nin; Gowland, Penny A.

Abstract

There is no well-established in vivo marker of nigral degeneration in Parkinson's disease (PD). An ideal imaging marker would directly mirror the loss of substantia nigra dopaminergic neurones, which is most prominent in sub-regions called nigrosomes. High-resolution, iron-sensitive, magnetic resonance imaging (MRI) at 7T allows direct nigrosome-1 visualisation in healthy people but not in PD. Here, we investigated the feasibility of nigrosome-1 detection using 3T - susceptibility-weighted (SWI) MRI and the diagnostic accuracy that can be achieved for diagnosing PD in a clinical population. 114 high-resolution 3T - SWI-scans were reviewed consisting of a prospective case-control study in 19 subjects (10 PD, 9 controls) and a retrospective cross-sectional study in 95 consecutive patients undergoing routine clinical SWI-scans (>50 years, 9 PD, 81 non-PD, 5 non-diagnostic studies excluded). Two raters independently classified subjects into PD and non-PD according to absence or presence of nigrosome-1, followed by consensus reading. Diagnostic accuracy was assessed against clinical diagnosis as gold standard. Absolute inter- and intra-rater agreement was ≥94% (kappa≥0.82, p

Citation

Schwarz, S., Afzal, M., Morgan, P., Auer, D., Bajaj, N., & Gowland, P. A. (2014). The ‘Swallow Tail’ Appearance of the Healthy Nigrosome – A New Accurate Test of Parkinson's Disease: A Case-Control and Retrospective Cross-Sectional MRI Study at 3T. PLoS ONE, 9(4), Article e93814. https://doi.org/10.1371/journal.pone.0093814

• Journal Article Type: Article
• Acceptance Date: Mar 6, 2014
• Online Publication Date: Apr 7, 2014
• Publication Date: Jan 1, 2014
• Deposit Date: Mar 22, 2018
• Publicly Available Date: Sep 11, 2019
• Journal: PLoS ONE
• Electronic ISSN: 1932-6203
• Publisher: Public Library of Science
• Peer Reviewed: Peer Reviewed
• Volume: 9
• Issue: 4
• Article Number: e93814
• DOI: https://doi.org/10.1371/journal.pone.0093814
• Public URL: https://nottingham-repository.worktribe.com/output/1096681
• Publisher URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0093814
• Contract Date: Jul 2, 2019