Substantia Nigra Volume Dissociates Bradykinesia and Rigidity from Tremor in Parkinson's Disease: A 7 Tesla Imaging Study.

TitleSubstantia Nigra Volume Dissociates Bradykinesia and Rigidity from Tremor in Parkinson's Disease: A 7 Tesla Imaging Study.
Publication TypeJournal Article
Year of Publication2020
AuthorsPoston KL, Cruadhlaoich MAIUa, Santoso LF, Bernstein JD, Liu T, Wang Y, Rutt B, Kerchner GA, Zeineh MM
JournalJ Parkinsons Dis
Volume10
Issue2
Pagination591-604
Date Published2020
ISSN1877-718X
KeywordsAged, Autopsy, Female, Gait Disorders, Neurologic, Humans, Hypokinesia, Magnetic Resonance Imaging, Male, Middle Aged, Muscle Rigidity, Parkinson Disease, Postural Balance, Red Nucleus, Severity of Illness Index, Substantia Nigra, Subthalamic Nucleus, Time Factors, Tremor
Abstract

BACKGROUND: In postmortem analysis of late stage Parkinson's disease (PD) neuronal loss in the substantial nigra (SN) correlates with the antemortem severity of bradykinesia and rigidity, but not tremor.

OBJECTIVE: To investigate the relationship between midbrain nuclei volume as an in vivo biomarker for surviving neurons in mild-to-moderate patients using 7.0 Tesla MRI.

METHODS: We performed ultra-high resolution quantitative susceptibility mapping (QSM) on the midbrain in 32 PD participants with less than 10 years duration and 8 healthy controls. Following blinded manual segmentation, the individual volumes of the SN, subthalamic nucleus, and red nucleus were measured. We then determined the associations between the midbrain nuclei and clinical metrics (age, disease duration, MDS-UPDRS motor score, and subscores for bradykinesia/rigidity, tremor, and postural instability/gait difficulty).

RESULTS: We found that smaller SN correlated with longer disease duration (r = -0.49, p = 0.004), more severe MDS-UPDRS motor score (r = -0.42, p = 0.016), and more severe bradykinesia-rigidity subscore (r = -0.47, p = 0.007), but not tremor or postural instability/gait difficulty subscores. In a hemi-body analysis, bradykinesia-rigidity severity only correlated with SN contralateral to the less-affected hemi-body, and not contralateral to the more-affected hemi-body, possibly reflecting the greatest change in dopamine neuron loss early in disease. Multivariate generalized estimating equation model confirmed that bradykinesia-rigidity severity, age, and disease duration, but not tremor severity, predicted SN volume.

CONCLUSIONS: In mild-to-moderate PD, SN volume relates to motor manifestations in a motor domain-specific and laterality-dependent manner. Non-invasive in vivo 7.0 Tesla QSM may serve as a biomarker in longitudinal studies of SN atrophy and in studies of people at risk for developing PD.

DOI10.3233/JPD-191890
Alternate JournalJ Parkinsons Dis
PubMed ID32250317
PubMed Central IDPMC7242837
Grant ListK23 NS075097 / NS / NINDS NIH HHS / United States
P50 AG047366 / AG / NIA NIH HHS / United States
P41 EB015891 / EB / NIBIB NIH HHS / United States
S10 RR026351 / RR / NCRR NIH HHS / United States
Related Institute: 
MRI Research Institute (MRIRI)

Weill Cornell Medicine
Department of Radiology
525 East 68th Street New York, NY 10065