Association of susceptibility weighted imaging and mild parkinsonian signs in patients with small vessel disease




parkinsonian symptoms, subcortical structures, magnetic resonance imaging


Background. Mild parkinsonian signs (MPS) can occur as a result of neurodegenerative diseases, cerebral small vessel disease (SVD) or manifest as a consequence of these two processes that occur simultaneously. Objective of this study was to identify whether there is a correlation between changes in magnetic susceptibility of subcortical brain structures and the presence of mild parkinsonian signs in patients with SVD. Materials and methods. Eighty two elderly participants with SVD and without known neurodegenerative diseases were included in this analysis and underwent magnetic resonance imaging: T1­weighted imaging, T2­weighted imaging, turbo inversion recovery magnitude, diffusion­weighted imaging, susceptibility weighted imaging (SWI) sequences. Presence of MPS was detected with the help of the third section of the Unified Parkinson’s Disease Rating Scale. Results. Using Mann­Whitney U test it was found that patients with MPS had statistically higher subcortical structure susceptibility rates and thus they had higher counts of hypointense voxels on the SWI. 3D Slicer Software was used to perform subcortical structure segmentation according to the signal intensity rates. In patients with MPS, more hypointense voxels were found in globus pallidus, putamen and substantia nigra of both hemispheres. After adjusting for age and the Fazekas score, MPS were most associated with an increased number of severe hypointensity voxels (signal intensity < 75) in right globus pallidus: odds ratio 1.29, confidence interval 1.08–1.55. Conclusions. Increased hypointensity of subcortical structures detected using SWI may be associated with MPS in patients with cerebral small vessel disease.


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Original Researches