1
Methods: Fifty four PD patients (22 women, 32 men; mean age 58 years, 28–78; Hoehn and Yahr stages 1: n = 27, 2: n = 16, 3: n = 9, 4: n = 2) underwent TCS and MIBG scintigraphy in a close time span of <1 month. Results: The extent of SN+ area was 0.224 ± 0.062 cm 2 (range 0.10– 0.40). MIBG uptake ratio (heart/mediastinum) was 1.458 ± 0.292 (range 1.00–2.09). There was no significant correlation between the TCS and MIBG scintigraphy findings (r = 0.12, p = 0.38; Pearson correlation coefficient). Conclusion: We could confirm the former findings of Kajimoto et al. in our German cohort with a lacking correlation between MIBG scintigraphy and TCS findings. The comparison of both methods underlines that SN+ does not allow quantification of nigral neurode- generation in any stage of PD. Both methods show different aspects of the disease and may be used complementarily. Whereas sensi- tivity may be higher in MIBG scintigraphy TCS seems to be the neuroimaging tool that shows pathological findings in suspected PD patients earliest. This may have implications for the physician using TCS in clinical syndromes suggestive for very early even premotor PD. doi:10.1016/j.baga.2011.01.064 P145 Akinetic-rigid and tremor-dominant Parkinson’s disease patients show different patterns of FP-CIT SPECT C. Eggers, D. Kahraman, G.R. Fink, M. Schmidt, L. Timmermann (Cologne) Objective: To elucidate whether Parkinson’s disease (PD) subtypes show a different pattern of FP-CIT SPECT binding in accordance with neuropathological findings. Background: Parkinson’s disease (PD) is a progressive neurodegener- ative disease with motor deficits characterized by bradykinesia, rigidity, tremor and postural instability. There are clear clinical proofs that the different subtypes of PD have a different clinical course. tremordominant patients show a slower progress of the dis- ease and less cognitive decline. Methods: We analysed a database of consecutive patients with FP- CIT scan (n = 190) over a 3-year period and identified 122 patients (50 females, 72 males, mean age 62 ± 11.1 years) with a diagnosis of idiopathic Parkinson’s disease (PD). Patient’s characteristics and FP-CIT scan results were analysed and compared for the subgroups tremor-dominant versus akinetic-rigid and equivalent type of Par- kinson’s disease. Results: The analysis of all PD patients showed a significant differ- ence between the FP-CIT- uptake in the subgroups tremor-dominant and akinetic-rigid. After matching these samples for age, disease- duration, disease severity (Hoehn & Yahr grade, UPDRS score) and Dopa-equivalent-dose these findings were balanced between both groups (n = 23/23) without a significant difference (p > 0.05). How- ever, there was a clear, significant association of visually analysed shapes of the striatum in FP-CIT SPECT and clinical PD subtype. Conclusion: These results confirm neuropathological models for a re- duced dopaminergic projection to the dorsal putamen in akinetic-ri- gid patients as well as the lateral putamen and caudate nucleus in tremor-dominant patients in vivo. doi:10.1016/j.baga.2011.01.065 P146 Human body fat percentage determination in Parkinson’s dis- ease: A pilot MRI study A. Unrath, H.-P. Müller, F. Raudies, H. Neumann, A.C. Ludolph, J. Kassubek (Ulm) Introduction: There is growing interest concerning the automated detection of fat tissue volumes from whole body MRI since MRI- based evaluation of adipose tissue quantity and regional distribution in the course of neurodegenerative diseases affecting body weight might be further evaluated. This pilot study is dedicated to investi- gate the possibility of detecting body fat percentage by MRI. Methods: MRI data were acquired on a clinical 1.5 T MRI scanner. The whole body MRI scan was performed in 60 patients with Parkinson’s disease and 60 age-matched healthy subjects by acquisition of 6–8 T1-weighted volumes, each consisting of 36 2-D slices. Data were diffusion filtered prior to application of the fat determination algo- rithm ARTIS (Adapted Rendering for Tissue Intensity Segmentation). Subcutaneous and visceral fat could be visualized and quantitative volume analysis was performed by use of ATLAS (Automatic Tissue Labelling Analysis Software) [1]. Results: By application of MRI-based fat volume determination, sep- arate regions of the body could be analyzed, resulting in a highly sensitive determination for fat volume changes caused by disease- related or medical conditions. The identification and quantification of the body fat and the differentiation between subcutaneous and visceral fat might be meaningful for the understanding of the course of the disease. Figure 1: Results for fat volume determination by ARTIS – subcuta- neous fat (red) and visceral fat (green). First results in patients with PD showed a tendency of reduced ratios of subcutaneous fat/total volume and total fat volume/total volume, while the ratio of visceral/subcutaneous fat was elevated in the patient group. Here, MRI-based fat volume quantification seems more sensitive than other parameters of body composition, e.g. the body mass index (BMI) which did not differ between groups. Conclusion: The concept of this pilot study was to determine the sub- cutaneous as well as the visceral fat volume in PD. Changes in regio- nal fat composition were observed in comparison with controls. Further work will be focussed on the assessment of changes in body fat composition in the course of various neurodegenerative diseases and conditions affecting fat tissue quantity. References [1] Müller H-P, Raudies F, Unrath A, Neumann H, Ludolph AC, Kassubek J. Quanti- fication of human body fat tissue percentage by magnetic resonance imaging. NMR Biomed, 2010 (online: <http://www.interscience.wiley.com>, doi:10.1002/ nbm.1549 ). doi:10.1016/j.baga.2011.01.066 P147 Comparison of the MRI of the paravertebral muscles in PD patients with and without camptocormia N. Margraf, A. Rohr, O. Jansen, G. Deuschl (Kiel) Objective: Camptocormia is an involuntary, marked flexion of the thoracolumbar spine that is frequently observed in movement disor- ders and especially in idiopathic Parkinson’s disease (PD). The objec- tive of our study was to describe in detail the features of magnetic resonance imaging (MRI) of camptocormia in PD. 34 Abstract / Basal Ganglia 1 (2011) 13–45

P146 Human body fat percentage determination in Parkinson’s disease: A pilot MRI study

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Methods: Fifty four PD patients (22 women, 32 men; mean age 58 years,28–78; Hoehn and Yahr stages 1: n = 27, 2: n = 16, 3: n = 9, 4: n = 2)underwent TCS and MIBG scintigraphy in a close time span of <1 month.Results: The extent of SN+ area was 0.224 ± 0.062 cm2 (range 0.10–0.40). MIBG uptake ratio (heart/mediastinum) was 1.458 ± 0.292(range 1.00–2.09). There was no significant correlation betweenthe TCS and MIBG scintigraphy findings (r = �0.12, p = 0.38; Pearsoncorrelation coefficient).Conclusion: We could confirm the former findings of Kajimoto et al.in our German cohort with a lacking correlation between MIBGscintigraphy and TCS findings. The comparison of both methodsunderlines that SN+ does not allow quantification of nigral neurode-generation in any stage of PD. Both methods show different aspectsof the disease and may be used complementarily. Whereas sensi-tivity may be higher in MIBG scintigraphy TCS seems to be theneuroimaging tool that shows pathological findings in suspectedPD patients earliest. This may have implications for the physicianusing TCS in clinical syndromes suggestive for very early evenpremotor PD.

doi:10.1016/j.baga.2011.01.064

P145Akinetic-rigid and tremor-dominant Parkinson’s disease patientsshow different patterns of FP-CIT SPECTC. Eggers, D. Kahraman, G.R. Fink, M. Schmidt, L. Timmermann (Cologne)

Objective: To elucidate whether Parkinson’s disease (PD) subtypesshow a different pattern of FP-CIT SPECT binding in accordance withneuropathological findings.Background: Parkinson’s disease (PD) is a progressive neurodegener-ative disease with motor deficits characterized by bradykinesia,rigidity, tremor and postural instability. There are clear clinicalproofs that the different subtypes of PD have a different clinicalcourse. tremordominant patients show a slower progress of the dis-ease and less cognitive decline.Methods: We analysed a database of consecutive patients with FP-CIT scan (n = 190) over a 3-year period and identified 122 patients(50 females, 72 males, mean age 62 ± 11.1 years) with a diagnosisof idiopathic Parkinson’s disease (PD). Patient’s characteristics andFP-CIT scan results were analysed and compared for the subgroupstremor-dominant versus akinetic-rigid and equivalent type of Par-kinson’s disease.Results: The analysis of all PD patients showed a significant differ-ence between the FP-CIT- uptake in the subgroups tremor-dominantand akinetic-rigid. After matching these samples for age, disease-duration, disease severity (Hoehn & Yahr grade, UPDRS score) andDopa-equivalent-dose these findings were balanced between bothgroups (n = 23/23) without a significant difference (p > 0.05). How-ever, there was a clear, significant association of visually analysedshapes of the striatum in FP-CIT SPECT and clinical PD subtype.Conclusion: These results confirm neuropathological models for a re-duced dopaminergic projection to the dorsal putamen in akinetic-ri-gid patients as well as the lateral putamen and caudate nucleus intremor-dominant patients in vivo.

doi:10.1016/j.baga.2011.01.065

P146Human body fat percentage determination in Parkinson’s dis-ease: A pilot MRI studyA. Unrath, H.-P. Müller, F. Raudies, H. Neumann, A.C. Ludolph, J. Kassubek(Ulm)

Introduction: There is growing interest concerning the automateddetection of fat tissue volumes from whole body MRI since MRI-based evaluation of adipose tissue quantity and regional distributionin the course of neurodegenerative diseases affecting body weightmight be further evaluated. This pilot study is dedicated to investi-gate the possibility of detecting body fat percentage by MRI.Methods: MRI data were acquired on a clinical 1.5 T MRI scanner. Thewhole body MRI scan was performed in 60 patients with Parkinson’sdisease and 60 age-matched healthy subjects by acquisition of 6–8T1-weighted volumes, each consisting of 36 2-D slices. Data werediffusion filtered prior to application of the fat determination algo-rithm ARTIS (Adapted Rendering for Tissue Intensity Segmentation).Subcutaneous and visceral fat could be visualized and quantitativevolume analysis was performed by use of ATLAS (Automatic TissueLabelling Analysis Software) [1].Results: By application of MRI-based fat volume determination, sep-arate regions of the body could be analyzed, resulting in a highlysensitive determination for fat volume changes caused by disease-related or medical conditions. The identification and quantificationof the body fat and the differentiation between subcutaneous andvisceral fat might be meaningful for the understanding of the courseof the disease.

Figure 1: Results for fat volume determination by ARTIS – subcuta-neous fat (red) and visceral fat (green).First results in patients with PD showed a tendency of reduced ratiosof subcutaneous fat/total volume and total fat volume/total volume,while the ratio of visceral/subcutaneous fat was elevated in thepatient group. Here, MRI-based fat volume quantification seemsmore sensitive than other parameters of body composition, e.g. thebody mass index (BMI) which did not differ between groups.Conclusion: The concept of this pilot study was to determine the sub-cutaneous as well as the visceral fat volume in PD. Changes in regio-nal fat composition were observed in comparison with controls.Further work will be focussed on the assessment of changes in bodyfat composition in the course of various neurodegenerative diseasesand conditions affecting fat tissue quantity.

References

[1] Müller H-P, Raudies F, Unrath A, Neumann H, Ludolph AC, Kassubek J. Quanti-fication of human body fat tissue percentage by magnetic resonance imaging.NMR Biomed, 2010 (online: <http://www.interscience.wiley.com>, doi:10.1002/nbm.1549).

doi:10.1016/j.baga.2011.01.066

P147Comparison of the MRI of the paravertebral muscles in PDpatients with and without camptocormiaN. Margraf, A. Rohr, O. Jansen, G. Deuschl (Kiel)

Objective: Camptocormia is an involuntary, marked flexion of thethoracolumbar spine that is frequently observed in movement disor-ders and especially in idiopathic Parkinson’s disease (PD). The objec-tive of our study was to describe in detail the features of magneticresonance imaging (MRI) of camptocormia in PD.

34 Abstract / Basal Ganglia 1 (2011) 13–45