Periventricular White Matter Abnormalities on Diffusion Tensor Imaging of Postural Instability Gait Disorder Parkinsonism

Postural instability gait disorder is a motor subtype of Parkinson disease associated with predominant gait dysfunction. We investigated the periventricular white matter comprising longitudinal, thalamic, and callosal fibers using diffusion tensor MR Imaging and examined clinical correlates in a coh...

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Bibliographic Details
Published in:	American journal of neuroradiology : AJNR 2019-04, Vol.40 (4), p.609-613
Main Authors:	Tan, S Y Z, Keong, N C H, Selvan, R M P, Li, H, Ooi, L Q R, Tan, E K, Chan, L L
Format:	Article
Language:	eng
Subjects:	Adult Brain Brain - diagnostic imaging Brain - pathology Case-Control Studies Diffusion Tensor Imaging - methods Female Gait Disorders, Neurologic - diagnostic imaging Gait Disorders, Neurologic - etiology Gait Disorders, Neurologic - pathology Humans Leukoencephalopathies - diagnostic imaging Leukoencephalopathies - pathology Male Middle Aged Parkinson Disease - complications Parkinson Disease - diagnostic imaging Parkinson Disease - pathology Postural Balance - physiology Sensation Disorders - diagnostic imaging Sensation Disorders - etiology Sensation Disorders - pathology White Matter - diagnostic imaging White Matter - pathology
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Summary:	Postural instability gait disorder is a motor subtype of Parkinson disease associated with predominant gait dysfunction. We investigated the periventricular white matter comprising longitudinal, thalamic, and callosal fibers using diffusion tensor MR Imaging and examined clinical correlates in a cohort of patients with Parkinson disease and postural instability gait disorder and healthy controls. All subjects underwent the Tinetti Gait and Balance Assessment and brain MR imaging. The DTI indices (fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity) from ROIs dropped over the superior and inferior longitudinal fasciculi, inferior fronto-occipital fasciculus, anterior thalamic radiation, anterior and posterior limbs of the internal capsule, and the genu and body of corpus callosum were evaluated. Our findings showed that the superior longitudinal fasciculus, inferior longitudinal fasciculus, inferior fronto-occipital fasciculus, anterior thalamic radiation, genu of the corpus callosum, and body of the corpus callosum are more affected in postural instability gait disorder than in those with Parkinson disease or healthy controls, with more group differences among the longitudinal fibers. Only the callosal fibers differentiated the postural instability gait disorder and Parkinson disease groups. DTI measures in the superior longitudinal fasciculus, frontostriatal fibers (anterior thalamic radiation, anterior limb of the internal capsule), and genu of the corpus callosum fibers correlated with clinical gait severity. Findings from this case-control cohort lend further evidence to the role of extranigral pathology and, specifically, the periventricular fibers in the pathophysiology of postural instability gait disorder.
ISSN:	0195-6108 1936-959X