Substantia nigra fractional anisotropy is not a diagnostic biomarker of Parkinson's disease: A diagnostic performance study and meta-analysis.

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 r...

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Publicado en:European Radiology Vol. 27; no. 6; pp. 2640 - 2649
Autores principales: Hirata, Fabiana, Sato, João, Vieira, Gilson, Lucato, Leandro, Leite, Claudia, Bor-Seng-Shu, Edson, Pastorello, Bruno, Otaduy, Maria, Chaim, Khallil, Campanholo, Kenia, Novaes, Natalia, Melo, Luciano, Gonçalves, Márcia, Nascimento, Felipe, Teixeira, Manoel, Barbosa, Egberto, Amaro, Edson, Cardoso, Ellison, Hirata, Fabiana C C, Sato, João R
Formato: Journal Article
Publicado: Springer Nature Jun2017
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2017
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      pub: Springer Nature
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        atl: Substantia nigra fractional anisotropy is not a diagnostic biomarker of Parkinson's disease: A diagnostic performance study and meta-analysis.
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          Hirata, Fabiana
          Sato, João
          Vieira, Gilson
          Lucato, Leandro
          Leite, Claudia
          Bor-Seng-Shu, Edson
          Pastorello, Bruno
          Otaduy, Maria
          Chaim, Khallil
          Campanholo, Kenia
          Novaes, Natalia
          Melo, Luciano
          Gonçalves, Márcia
          Nascimento, Felipe
          Teixeira, Manoel
          Barbosa, Egberto
          Amaro, Edson
          Cardoso, Ellison
          Hirata, Fabiana C C
          Sato, João R
        affil: LIM-44, Department of Radiology , University of São Paulo , Rua Oscar Freire, 1967, Apto. 43A, Cerqueira César São Paulo Brazil
      sug:
      ab: 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 135 subjects: 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.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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