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Journal of Neurosurgical Sciences 2020 May 13

DOI: 10.23736/S0390-5616.20.04935-8

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

3T MRI-SWI based volumetric analysis of the subthalamic and red nuclei in advanced Parkinson’s disease

Varshesh SHAH 1, Rajesh ALUGOLU 1, Abhishek ARORA 2, Rukmini M. KANDADAI 3, Vijayasaradhi MUDUMBA 1, Rupam BORGOHAIN 3

1 Department of Neurosurgery, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India; 2 Radiology, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India; 3 Neurology, Nizam’s Institute of Medical Sciences, Hyderabad, Telangana, India


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BACKGROUND: Parkinson’s disease (PD) is a neurodegenerative disease mainly involving the dopaminergic neurons of the substantia nigra. The subthalamic nucleus (STN) also plays an important role in the disease process and now is an important target for the surgical management of the disease. However, not much is known about its morphology as the disease progresses.To evaluate the volume of STN and Red nucleus (RN) on 3T MRI SWI and its possible correlation with the disease in patients with advanced Parkinson’s disease.
METHODS: A total of 30 patients were enrolled. They were evaluated by analysis of symptomatology, UPDRS III, MOCA. Radiological evaluation included volumetric SWI images in 3T MRI. The volumes of the STN & RN were measured on SWI coronal images.
RESULTS: There were 24(80%) males and 6(20%) females. The mean volumes of STN & RN were 118.66mm3 (80-170 mm3) & 379.66 mm3(270-500mm3). There was no significant difference between right & left STN volumes & RN volumes. There was a significant positive correlation between the disease duration & RN volumes (p= 0.015) and STN volumes (in 6-13 years) (p= 0.001). STN & RN volumes were negatively correlated with MOCA scores in males (p=0.008 & p= 0.017), with no such correlation in females. In Late- Onset PD, there was a significant positive correlation between RN volume and UPDRS off & on scores (p=0.028 & p=0.03).
CONCLUSIONS: STN volumes show a positive trend as the disease duration increases and cognition declines. RN volumes also increase as the disease progresses.


KEY WORDS: Parkinson’s disease; Red nucleus; Sub thalamic nucleus; SWI (Susceptibility Weighted Images); Volumetric analysis

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