BACKGROUND Microstructural white matter integrity captured by diffusion-tensor imaging (DTI) is significantly more affected in progressive supranuclear palsy-Richardson's syndrome (PSP-RS) compared to PSP-parkinsonism (PSP-P). OBJECTIVES To characterize the microstructural integrity of large fascicular bundles using standardized probabilistic tractography and combine it with previously established DTI- and volumetric measures of subcortical brain structures in order to evaluate its diagnostic properties for the differentiation of PSP- RS, PSP-P and Parkinson's disease (PD). METHODS DTI metrics as well as volumes of subcortical brain regions, acquired by 3T MRI of patients with PSP-RS (n = 15), PSP-P (n = 13), and a mean disease duration of 2.7 ± 1.8 years, were quantified by probabilistic tractography as well as a validated infratentorial atlas and compared to PD (n = 18) and healthy controls (n = 20). Classification accuracy of MRI measures was tested by consecutive linear discriminant analyses. RESULTS DTI metrics of the anterior thalamic radiation, the corticospinal tract, the superior longitudinal fasciculus, the bundles of the corpus callosum and cingulate, the dentatorubrothalamic tract as well as volumes of the dorsal midbrain, globus pallidus and thalamus were significantly altered in PSP-RS and to a lesser extent in PSP-P compared to PD and healthy controls. Linear discriminant analysis identified DTI metrics of the dentatorubrothalamic tract and the anterior thalamic radiation as well as the volume of the dorsal midbrain to classify correctly 91.3% of PSP-RS, PSP-P and PD patients. CONCLUSIONS Observer-independent investigations of microstructural integrity of major fiber bundles improved existing MRI processing strategies to differentiate PSP-P from PSP-RS and PD, in their early disease stages.

中文翻译：

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进行性核上性麻痹变异的自动束线学诊断潜力。

背景技术与PSP-帕金森病（PSP-P）相比，在进行性核上性麻痹-理查森氏综合征（PSP-RS）中，扩散张量成像（DTI）捕获的微结构白质完整性受到的影响更大。目的使用标准化概率束描记法表征大束束束的微结构完整性，并将其与先前建立的皮层下脑结构的DTI和体积测量相结合，以评估其对PSP-RS，PSP-P和帕金森氏病鉴别的诊断性能（PD）。方法通过3T MRI对PSP-RS（n = 15），PSP-P（n = 13），平均疾病持续时间为2.7±1.8年的患者进行DTI指标以及皮层下大脑区域的测量，通过概率束摄影术以及经过验证的直肠下图谱进行量化，并与PD（n = 18）和健康对照（n = 20）进行比较。通过连续的线性判别分析测试了MRI测量的分类准确性。结果在PSP-RS中，前丘脑放射，皮质脊髓束，上纵筋膜，call体束和扣带束，齿下丘脑束以及背中脑，苍白球和丘脑的体积的DTI指标发生了显着变化与PD和健康对照组相比，PSP-P的影响较小。线性判别分析确定了齿状下丘脑束和前丘脑放射的DTI指标以及背中脑的体积，以正确分类91.3％的PSP-RS，PSP-P和PD患者。