Research Article Differential Diagnosis Tool for Parkinsonian Syndrome Using Multiple Structural Brain Measures

Copyright © 2013 Miho Ota et al.This is an open access article distributed under theCreativeCommonsAttribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Clinical differentiation of parkinsonian syndromes such as the Parkinson variant ofmultiple system atrophy (MSA-P) and cerebellar subtype (MSA-C) from Parkinson’s disease is difficult in the early stage of the disease. To identify the correlative pattern of brain changes for differentiating parkinsonian syndromes, we applied discriminant analysis techniques by magnetic resonance imaging (MRI). T1-weighted volume data and diffusion tensor images were obtained by MRI in eighteen patients with MSA-C, 12 patients withMSA-P, 21 patients with Parkinson’s disease, and 21 healthy controls.They were evaluated using voxel-basedmorphometry and tract-based spatial statistics, respectively. Discriminant functions derived by step wise methods resulted in correct classification rates of 0.89. When differentiating these diseases with the use of three independent variables together, the correct classification rate was the same as that obtained with step wise methods. These findings support the view that each parkinsonian syndrome has structural deviations in multiple brain areas and that a combination of structural brain measures can help to distinguis