Putaminal volume and diffusion in early familial Creutzfeldt–Jakob Disease

Seror, Ilana; Lee, Hedok; Cohen, Oren S.; Hoffmann, Chen; Prohovnik, Isak

doi:10.1016/j.jns.2009.09.019

« Previous Next »Journal of the Neurological Sciences
Volume 288, Issue 1 , Pages 129-134, 15 January 2010

Putaminal volume and diffusion in early familial Creutzfeldt–Jakob Disease

Ilana Seror
- Department of Psychiatry, Mount Sinai School of Medicine, P.O. Box 1230, One Gustave Levy Place, New York, NY 10029, USA
Hedok Lee
- Department of Psychiatry, Mount Sinai School of Medicine, P.O. Box 1230, One Gustave Levy Place, New York, NY 10029, USA
Oren S. Cohen
- Department of Neurology, Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel
Chen Hoffmann
- Department of Radiology, Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel
Isak Prohovnik
- Department of Psychiatry, Mount Sinai School of Medicine, P.O. Box 1230, One Gustave Levy Place, New York, NY 10029, USA
- Department of Radiology, Mount Sinai School of Medicine, P.O. Box 1230, One Gustave Levy Place, New York, NY 10029, USA
- Corresponding author. Department of Psychiatry, Mount Sinai Medical Center, P.O. Box 1230, One Gustave Levy Place, New York, NY 10029, United States. Tel.: +1 718 584 9000x3629.

Received 2 March 2009; received in revised form 17 August 2009; accepted 22 September 2009. published online 15 October 2009.

Abstract

Background

The putamen is centrally implicated in the pathophysiology of Creutzfeldt–Jakob Disease (CJD). To our knowledge, its volume has never been measured in this disease. We investigated whether gross putaminal atrophy can be detected by MRI in early stages, when the diffusion is already reduced.

Methods

Twelve familial CJD patients with the E200K mutation and 22 healthy controls underwent structural and diffusion MRI scans. The putamen was identified in anatomical scans by two methods: manual tracing by a blinded investigator, and automatic parcellation by a computerized segmentation procedure (FSL FIRST). For each method, volume and mean Apparent Diffusion Coefficient (ADC) were calculated.

Results

ADC was significantly lower in CJD patients (697±64µm²/s vs. 750±31µm²/s, p<0.005), as expected, but the volume was not reduced. The computerized FIRST delineation yielded comparable ADC values to the manual method, but computerized volumes were smaller than manual tracing values.

Conclusions

We conclude that significant diffusion reduction in the putamen can be detected by delineating the structure manually or with a computerized algorithm. Our findings confirm and extend previous voxel-based and observational studies. Putaminal volume was not reduced in our early-stage patients, thus confirming that diffusion abnormalities precede detectible atrophy in this structure.

Keywords: Putamen, VOI, ADC, CJD, E200K, FIRST, FSL, SPM