Objective: (1) To synthesize brain white matter changes with diffusion tensor imaging (DTI) in Parkinson’s disease (PD); and (2) to study correlations of these changes with clinical characteristics and their dependency on medical resonance imaging (MRI) acquisition parameters.

Background: PD is associated with diffuse brain alterations. Such alterations should be visible using DTI, a dedicated method to study macro-anatomical lesions or degenerations. Yet, no meta-analysis on DTI studies in PD is available so far.

Methods: We identified 31 studies matching our key-words’ literature search: 9 using fractional anisotropy (FA), 2 with mean diffusivity (MD) and 20 with both methods. This article selection represented 752 PD patients and 513 healthy controls. Our statistical meta-analysis reported the disease effect size (DES), the heterogeneity index and the Pearson correlation with clinical (gender, age, PD duration, mini mental state examination [MMSE]) and neuroimaging (voxel size, tesla, number of DTI directions, Repetition Time, Echo Time) co-variables.

Results: Significant DES for FA and MD was found, notably for caudate nucleus, fasciculus uncinate and cingulum: in these regions, differences were significantly discriminative between patients and controls. Moreover, results of DTI studies are dependent of clinical considerations. For PD patients with cognitive impairment or dementia, more diffuse alterations were detected. Cortical areas and corpus callosum were the most affected by the disease when it is associated with cognitive impairment. For all PD patients, MD and FA are sensitive to clinical and imaging co-variables (particularly PD duration and MMS-E score for FA, echo time for MD, voxel size for both).

Conclusions: DTI appears to be an effective method to study cerebral changes in PD. However, the study of cortical regions and white fibers are sensitive to artifacts because the nature of fibers induces a modification of anisotropy and water diffusivity.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/diffusion-tensor-imaging-in-parkinsons-disease-review-and-meta-analysis-with-clinical-considerations-and-neuroimaring-parameters/