Atypical parkinsonism
Conditions
Interventions
None listed
Sponsors
Erasmus MC, Universitair Medisch Centrum Rotterdam
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: Patients: - Patients who present at the outpatient clinic of the department of neurology with symptoms consistent with degenerative parkinsonism. - For possible PD patients: Diagnosis of Parkinson*s disease is unclear and an atypical form of parkinsonism is suspected. - For near-certain PD patients: Patients for whom Parkinson*s disease is highly suspected. - At least 50 years old - Signed informed consent. Healthy volunteers: - Healthy subject (defined as a volunteer without and signs or symptoms of disease) - At least 50 years old and not older than 75 - Signed informed consent
Exclusion criteria
Exclusion criteria: - Patients with parkinsonism symptoms caused by medication or essential tremors. In addition, both patients and healthy volunteers are excluded if they meet any of the following criteria: - a history of another neurodegenerative disease. - History of significant intracranial disease - Contra-indication to an MRI exam - Metal implants - Women who are pregnant or lactating - Having any physical or mental status that interferes with the informed consent procedure
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The differentiations will be made based on the following measurements: - Atrophy measurements will be made on a sagittal view of the T1-weighted images, without additional post-processing. This is done by measuring the surface and diameters of the midbrain, pons and superior and middle cerebral peduncle (8,9) for all the differentiations, and in addition for differentiating MSA-C from the rest can be improved by looking for a Hot-Cross-Bun Sign (HCBS) on a T2-weighted image in the pons (14,15). - MT-weighted measurements are made in the Substantia Nigra and Locus Coeruleus - Quantitative Susceptibility Mapping (QSM) will be done in the brain, including the basal ganglia (putamen and globus pallidus) (6,11) and the midbrain (nucleus ruber and substantia nigra) using, for example, the MEDI toolbox (16). - Diffusion MRI measures, including Fractional Anisotropy (FA) and Apparent Diffusion Coefficient (ADC) will be conducted in the brain, including the putamen, cerebellum and brainstem (12,17-20). This can, for example, be done using MRtrix (21). - Neurological examination including a UPDRS score (movement disorder severity) and MOCA score (Cognitive test). - Neurofilament quantification from a blood sample. | — |
Secondary
| Measure | Time frame |
|---|---|
| The same approaches as primary parameters will be applied, however each atypical form will be grouped separately. | — |
Countries
Netherlands
Outcome results
None listed