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Brain Advance Access originally published online on November 4, 2005
Brain 2006 129(2):538-542; doi:10.1093/brain/awh674
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© The Author (2005). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Voxel-wise analysis of diffusion weighted imaging reveals disruption of the olfactory tract in Parkinson's disease

Christoph Scherfler1, Michael F. Schocke2, Klaus Seppi1, Regina Esterhammer2, Christian Brenneis1, Werner Jaschke2, Gregor K. Wenning1 and Werner Poewe1

Departments of 1 Neurology and 2 Radiotherapy, Innsbruck Medical University, Innsbruck, Austria

Correspondence to: Dr Christoph Scherfler, Department of Neurology, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria E-mail: christoph.scherfler{at}uibk.ac.at

Diffusion weighted imaging (DWI) and the trace of diffusion tensor [Trace (D)], a marker of water molecule diffusivity, provide information on structural integrity of nervous tissues. To investigate structural lesions within the brain's neuronal architecture in early stages of Parkinson's disease, 12 patients with disease duration of 3.5 ± 1.5 years were studied with DWI. Data were compared with 12 age-matched healthy control subjects. To objectively localize focal changes of structural neuronal integrity without having to make an a priori hypothesis as to its location statistical parametric mapping (SPM) was applied to our DWI study. SPM localized significant increases of diffusivity in the region of both olfactory tracts in patients (P < 0.001). Trace (D) cut-off values for the voxel cluster of the olfactory tracts have been calculated from the subjects entered into SPM and applied to a total of 17 different individuals (9 patients with Parkinson's disease, disease duration 3.1 ± 1.3 years and 8 age-matched healthy subjects). Out of 17 subjects, 16 subjects, i.e. 94%, were correctly discriminated with a sensitivity of 100% and a specificity of 88%. All patients with Parkinson's disease were correctly classified and only one normal subject was classified as having the disease, underlining the high potential of this method to separate patients with the illness from healthy subjects. Increased diffusivity in the olfactory tract is in line with the well-established clinical finding of hyposmia in Parkinson's disease. Whether DWI can be used as a marker to identify individuals at risk to develop this disease remains to be shown.

Key Words: Parkinson's disease; diffusion weighted imaging; statistical parametric mapping; olfactory tract; trace of diffusion tensor

Abbreviations: ADC = apparent diffusion coefficient; DWI = diffusion weighted imaging; ROI = region of interest; SPM = statistical parametric mapping; Trace (D) = trace of diffusion tensor; UPDRS = Unified Parkinson's Disease Rating Scale

Received July 10, 2005. Revised September 11, 2005. Accepted October 3, 2005.


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