![]() J Neurol Sci 71(2–3):193–208īaloh RW, Yee RD, Honrubia V (1986) Late cortical cerebellar atrophy. Kanazawa I, Kwak S, Sasaki H, Mizusawa H, Muramoto O, Yoshizawa K et al (1985) Studies on neurotransmitter markers and neuronal cell density in the cerebellar system in olivopontocerebellar atrophy and cortical cerebellar atrophy. Klockgether T (2012) Sporadic adult-onset ataxia of unknown etiology. J Neurol Neurosurg Psychiatry 65(1):65–71Ībele M, Burk K, Schols L, Schwartz S, Besenthal I, Dichgans J et al (2002) The aetiology of sporadic adult-onset ataxia. Schrag A, Kingsley D, Phatouros C, Mathias CJ, Lees AJ, Daniel SE et al (1998) Clinical usefulness of magnetic resonance imaging in multiple system atrophy. Wakabayashi K, Takahashi H (2006) Cellular pathology in multiple system atrophy. Tsuji S, Onodera O, Goto J, Nishizawa M, Study Group on Ataxic D (2008) Sporadic ataxias in Japan–a population-based epidemiological study. Gilman S, Low PA, Quinn N, Albanese A, Ben-Shlomo Y, Fowler CJ et al (1999) Consensus statement on the diagnosis of multiple system atrophy. ![]() When combining the FA values of efferent 1 with disease duration, the present DTI tractography analysis could be useful for differentiating MSA-C and CCA patients. The present DTI tractography newly showed that the FA values of two afferent fiber tracts showed significant declines in MSA-C patients, and afferent 1 showed good diagnostic sensitivity and specificity. Linear regressions showed strong correlations between FA value and disease duration in CCA patients (efferent 1, r = −0.466 afferent 2, r = −0.543 both p < 0.05), and between the FA value and the ratio of the standardized scale for the assessment and rating of ataxia (SARA)/disease duration in MSA-C patients (afferent 1, r = −0.407 p < 0.01). Receiver-operator characteristic curve analysis showed 85.7 % sensitivity and 75.0 % specificity of FA values in afferent 1 (cutoff value 0.476). Compared with CCA, MSA-C patients showed significant declines of fractional anisotropy (FA) values of afferent 1 and 2 ( p < 0.01, respectively) and a significant increase of the radial diffusivity (RD) value in afferent 1 ( p < 0.05). Tractography was performed using the DTI track module provided in the MedINRIA version 1.9.4, and regions of interest were drawn manually to reconstruct an efferent fiber tract and two afferent fiber tracts via the cerebellum. Forty-one MSA-C patients (62.7 ± 8.1 years old, mean ± SD) and age- and gender-matched 15 CCA patients (63.0 ± 8.6 years old) were examined. ![]() Its visualisation might help to adjust targeting in DBS for psychiatric disorders.The objective of this study is to determine whether diffusion tensor imaging (DTI) tractography analysis is a potential method for differentiating cerebellar ataxia patients with multiple system atrophy with predominant cerebellar ataxia (MSA-C) and cortical cerebellar atrophy (CCA). Fibre tracts starting from the contralateral SCP follow a more superior and lateral course, including the dentato-rubro-thalamic and the pyramidal tract.ĭeterministic fibre tracking with standardised ROIs provides constant and reproducible delineations of the medial forebrain bundle. Consistently, a branch leaves the main fibre tract laterally to take a course through the capsula externa to the temporo-parietal cortex. These fibres are in accordance with the course of the MFB as described in various anatomical atlases. The fibre tracts starting in seed regions in the ipsilateral SCP and the NRD follow a similar course along the lateral wall of the third ventricle (hypothalamus) and the anterior limb of the internal capsule (ALIC) to inferior fronto-medial brain areas. Minimal fibre length was set at 30 mm and the FA threshold at 0.12. From each seed region the fibres were followed separately through the ventral tegmental area (VTA = second ROI) and their further courses and volumina were documented and compared. Three different regions of interest (ROIs) were defined as seed regions for fibre tracking: the ipsilateral and contralateral superior cerebellar peduncle (SCP) and the nucleus raphe dorsalis (NRD). Twenty-two cerebral hemispheres in 11 patients were investigated. The aim of our study was to find standardised parameters for diffusion tensor imaging (DTI) based fibre tracking to reliably visualise the MFB. Deep brain stimulation (DBS) of the medial forebrain bundle (MFB) was reported to reduce symptoms in psychiatric disorders.
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