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Quantitative Validation of a Visual Rating Scale for Defining High-Iron Putamen in Patients With Multiple System Atrophy
- Source :
- Frontiers in Neurology, Frontiers in Neurology, Vol 10 (2019)
- Publication Year :
- 2019
-
Abstract
- Objectives: To validate a visual rating scale reflecting sub-regional patterns of putaminal hypointensity in susceptibility-weighted imaging of patients with multiple system atrophy (MSA).Methods: Using a visual rating scale (from G0 to G3), 2 examiners independently rated putaminal hypointensities of 37 MSA patients and 21 control subjects. To investigate the correlation with the scales, R2* values and the volume of the entire putamen were measured.Results: MSA patients with parkinsonian variant had significantly higher scores than those with cerebellar variant. Visual rating scores in MSA were correlated with R2* values [General estimating equation (GEE), Wald chi-square = 25.89, corrected p < 0.001] and volume (Wald chi-square = 75.44, corrected p < 0.001). They correlated with UPDRS motor scores. Binary logistic regression analyses revealed that the visual rating scale was a significant predictor for discriminating MSA patients from controls [multivariate model adjusted for age and sex, odds ratio 52.722 (corrected p = 0.009)]. Pairwise comparison between areas under the curve (AUCs) revealed that the visual rating scale demonstrated higher accuracy than R2* values [difference between AUCs; univariate model = 0.247 (corrected p < 0.001); multivariate model = 0.186 (corrected p = 0.003)]. There were no significant differences in clinical characteristics between the high-iron group, defined as putamen with visual rating scale ≥ G2 and R2* values ≥ third quartile, and the remaining patients.Conclusion: The visual rating scale, which reflects quantitative iron content and atrophy of the putamen as well as motor severities, could be useful for the discrimination and evaluation of patients with MSA.
- Subjects :
- 0301 basic medicine
Multivariate statistics
medicine.medical_specialty
Scale (ratio)
putaminal hypointensity
multiple system atrophy
brain MR image
Audiology
Logistic regression
lcsh:RC346-429
Correlation
03 medical and health sciences
0302 clinical medicine
Atrophy
visual rating scale
medicine
lcsh:Neurology. Diseases of the nervous system
susceptibility weight imaging
business.industry
Putamen
Odds ratio
Brief Research Report
medicine.disease
030104 developmental biology
Quartile
Neurology
Neurology (clinical)
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 16642295
- Volume :
- 10
- Database :
- OpenAIRE
- Journal :
- Frontiers in neurology
- Accession number :
- edsair.doi.dedup.....13ea68e29b5b4a11e54e9e73c517b6c4