Objective: To investigate the utility of Neuro-Melanin sensitive MRI (NMI) by 3T MRI for diagnosis, the relationship and severity in Parkinson’s disease (PD) and related disorders.

Background: Several reports have shown that NMI by 3T MRI is useful for differential diagnosis of PD, progressive supranuclear palsy (PSP) and so on. Our previous research suggests that NMI is also helpful in tracking possible changes in PD over time. However, in the past various studies, the number of cases has not been sufficient.

Method: We investigated the results of diagnosis and NMI for a total of 591 patients (531 subjects except for duplication) who underwent NMI from October 2010 to December 2018.

Results: Each clinical diagnosis was described below. Eleven normal (NC) (average 74.6 years old), 244 patients with PD (average 68.5 years old), 30 patients with dementia with Lewy bodies (DLB) (average 76.4 years old), 21 patients with vascular parkinsonism (average 76.1 years old), 18 patients with drug-induced parkinsonism (average 66.1 years old), 49 patients with PSP (average 72.5 years old), 19 patients with corticobasal syndrome (CBS) (average 70.7 years old), 19 patients with multiple system atrophy with predominant parkinsonism (MSA-P) (average of 66.6 years old), 11patients with multiple system atrophy with predominated in cerebellar ataxia (MSA-C) (average of 68.0 years old), 10 patients with essential tremor  (average 76.8 years), 7 patients with spinocerebellar degeneration (SCD) (average 47.1 years old), 92 patients with others (including undiagnosed). The substantia nigra area (SN-AREA) of PD, DLB, PSP, CBS, MSA-P and SCD (14.9±9.1, 15.5±12.1, 11.0±11.2, 14.8±12.4, 15.0±12.4 and 9.3±8.2 pixels, respectively.) was significantly smaller than that of NC (40.1±9.9 pixels、All P values are < 0.001.).The contrast ratio of locus coeruleus (LC) in PD, DLB and MSA-C (3.9±3.6, 3.9±3.9 and 2.8±3.9% respectively.) was smaller than that of NC (8.8±2.7%, p<0.001, p=0.055 and p=0.110, respectively). Also, the contrast ratio of LC in PD (3.9±3.6%) was significantly smaller than that of PSP and CBS (8.6±2.8 and 7.7±3.3%, p<0.001 and p<0.001, respectively). Notably, the case of hyperammonemia showed remarkably high intensity in SN on NMI.

Conclusion: It seems that NMI contributes to clinical diagnosis and differentiation in neurodegenerative diseases such as PD, PSP, and MSA-P.

References: Sasaki M, Shibata E, Tohyama K, Takahashi J, Otsuka K, Tsuchiya K, et al. Neuromelanin magnetic resonance imaging of locus ceruleus and substantia nigra in Parkinson’s disease. Neuroreport. 2006 (11):1215–8. Ohtsuka C, Sasaki M, Konno K, Kato K, Takahashi J, Yamashita F, et al. Differentiation of early-stage parkinsonisms using neuromelanin-sensitive magnetic resonance imaging. Parkinsonism Relat Disord. 2014; 20(7): 755–60. Taniguchi D, Hatano T, Kamagata K, Okuzumi A, Oji Y, Mori A, et al. Neuromelanin imaging and midbrain volumetry in progressive supranuclear palsy and Parkinson’s disease. Mov Disord. 2018; 33(9):1488–92. Matsuura K, Maeda M, Tabei K, Umino M, Kajikawa H, Satoh M, et al. A longitudinal study of neuromelanin-sensitive magnetic resonance imaging in Parkinson’s disease. Neurosci Lett. 2016; 633: 112–7. Matsuura K, Maeda M, Yata K, Ichiba Y, Yamaguchi T, Kanamaru K, et al. Neuromelanin magnetic resonance imaging in Parkinson’s disease and multiple system atrophy. Eur Neurol. 2013; 70(1–2): 70–7.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/investigation-of-531-cases-of-neuromelanin-sensitive-imaging-about-its-characteristics-by-disease/