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Brain Advance Access published online on November 4, 2005
Brain, 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
Received July 10, 2005
Revised September 11, 2005
Accepted October 3, 2005

Article

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

Christoph Scherfler 1*, Michael F. Schocke 2, Klaus Seppi 1, Regina Esterhammer 2, Christian Brenneis 1, Werner Jaschke 2, Gregor K. Wenning 1, and Werner Poewe 1

1 Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
2 Department of Radiotherapy, Innsbruck Medical University, Innsbruck, Austria

* To whom correspondence should be addressed.
Christoph Scherfler, E-mail: christoph.scherfler{at}uibk.ac.at


  Abstract

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.

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