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Published online before print June 23, 2004, 10.1148/radiol.2322030820
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(Radiology 2004;232:867-873.)
© RSNA, 2004

Neuroradiology

Huntington Disease: Volumetric, Diffusion-weighted, and Magnetization Transfer MR Imaging of Brain1

Mario Mascalchi, MD, PhD, Francesco Lolli, MD, PhD, Riccardo Della Nave, MD, Carlo Tessa, MD, Raffaele Petralli, MD, Cinzia Gavazzi, MD, Letterio S. Politi, MD, Marco Macucci, MD, PhD, Massimo Filippi, MD and Silvia Piacentini, MD

1 From the Radiodiagnostic Section, Department of Clinical Physiopathology (M. Mascalchi, R.D.N., C.T., C.G., L.S.P.) and Department of Neurological Sciences (F.L., R.P., S.P.), University of Florence, Viale Morgagni 85, Florence, Italy; Unit of Neurophysiopathology, Empoli General Hospital, Italy (M. Macucci); and Neuroimaging Research Unit, Department of Neurology, University Hospital San Raffaele, Milan, Italy (M.F.). Received June 3, 2003; revision requested August 14; final revision received December 29; accepted January 29, 2004. Address correspondence to M. Mascalchi (e-mail: m.mascalchi@dfc.unifi.it).

PURPOSE: To investigate whether diffusion-weighted and magnetization transfer (MT) magnetic resonance (MR) imaging depict regional and/or global brain abnormalities in patients with Huntington disease (HD).

MATERIALS AND METHODS: Twenty-one carriers of the HD mutation (mean age, 58 years ± 11 [SD]) and 21 healthy control subjects (mean age, 54 years ± 13) underwent conventional, diffusion-weighted, and MT MR imaging. Volumes, mean apparent diffusion coefficients (ADCs), and MT ratios (MTRs) for left and right caudate nucleus, putamen, and cerebral periventricular white matter—as well as an index of normalized brain volume and whole-brain ADC and MT histograms—were computed. Asymmetry in volume, ADC, and MTR measurements in caudate nucleus, putamen, and periventricular white matter in control subjects and HD carriers were evaluated with Wilcoxon testing for paired samples. Differences in MR imaging variables between HD carriers and control subjects were evaluated with Mann-Whitney U testing; correlations between stages of clinical severity and MR imaging data were investigated with Spearman rank correlation testing.

RESULTS: No significant asymmetry was observed for any of the MR imaging variables. Caudate nucleus, putamen, and whole-brain volumes were smaller (P < .001 for all) in HD carriers than in control subjects. HD carriers also had increased ADC in the caudate nucleus (P = .002), putamen (P <. 001), cerebral periventricular white matter (P < .001), and whole brain (P < .001). MTR was not significantly different between HD carriers and control subjects. Correlation was observed between stages of increasing clinical disease severity and both decrease in volume of caudate nucleus (Spearman {rho} = –0.63), putamen ({rho} = –0.64), and whole brain ({rho} = –0.46) and increase in ADC in caudate nucleus ({rho} = 0.52), periventricular white matter ({rho} = 0.45), and whole brain ({rho} = 0.44).

CONCLUSION: Regional and global volume loss in HD is accompanied by an increase in ADC; this correlates with disease severity.

© RSNA, 2004

Index terms: Brain, diffusion, 10.12144 • Brain, diseases, 10.884 • Brain, MR, 10.121417, 10.12144 • Huntington disease, 10.884 • Magnetic resonance (MR), diffusion tensor, 10.12144 • Magnetic resonance (MR), magnetization transfer, 10.121417




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