Substantia nigra fractional anisotropy is not a diagnostic biomarker of Parkinson's disease: A diagnostic performance study and meta-analysis.
Eur Radiol
; 27(6): 2640-2648, 2017 Jun.
Article
em En
| MEDLINE
| ID: mdl-27709279
ABSTRACT
OBJECTIVES:
Our goal was to estimate the diagnostic accuracy of substantia nigra fractional anisotropy (SN-FA) for Parkinson's disease (PD) diagnosis in a sample similar to the clinical setting, including patients with essential tremor (ET) and healthy controls (HC). We also performed a systematic review and meta-analysis to estimate mean change in SN-FA induced by PD and its diagnostic accuracy.METHODS:
Our sample consisted of 135subjects:
72 PD, 21 ET and 42 HC. To address inter-scanner variability, two 3.0-T MRI scans were performed. MRI results of this sample were pooled into a meta-analysis that included 1,432 subjects (806 PD and 626 HC). A bivariate model was used to evaluate diagnostic accuracy measures.RESULTS:
In our sample, we did not observe a significant effect of disease on SN-FA and it was uninformative for diagnosis. The results of the meta-analysis estimated a 0.03 decrease in mean SN-FA in PD relative to HC (CI 0.01-0.05). However, the discriminatory capability of SN-FA to diagnose PD was low pooled sensitivity and specificity were 72 % (CI 68-75) and 63 % (CI 58-70), respectively. There was high heterogeneity between studies (I2 = 91.9 %).CONCLUSIONS:
SN-FA cannot be used as an isolated measure to diagnose PD. KEY POINTS ⢠SN-FA appears insufficiently sensitive and specific to diagnose PD. ⢠Radiologists must be careful when translating mean group results to clinical practice. ⢠Imaging protocol and analysis standardization is necessary for developing reproducible quantitative biomarkers.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doença de Parkinson
/
Substância Negra
Tipo de estudo:
Diagnostic_studies
/
Guideline
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Prognostic_studies
/
Systematic_reviews
Limite:
Aged
/
Female
/
Humans
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Male
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article