Delayed parkinsonism after CO intoxication: Evaluation of the substantia nigra with inversion-recovery MR imaging
Journal
Radiology
Journal Volume
265
Journal Issue
1
Pages
215-221
Date Issued
2012
Author(s)
Abstract
Purpose: To quantitatively investigate signal alterations of the substantia nigra in patients with delayed parkinsonism following CO intoxication, as seen on gray matter (GM)-suppressed inversion-recovery (IR) magnetic resonance (MR) images. Materials and Methods: This prospective study was approved by the local institutional review board, and written informed consent was obtained from all subjects. Thirteen patients with delayed onset of CO-induced parkinsonism (nine men and four women; mean age, 40.3 years), 13 age-matched CO-intoxicated patients without parkinsonism, and 13 age-matched healthy volunteers were examined with GM-suppressed IR MR imaging. The signal intensity of the substantia nigra was normalized to the adjacent normalappearing white matter in the temporal lobe, followed by semiautomatic segmentation into medial, middle, and lateral parts by using a skeleton-based algorithm. Multivariate and univariate analyses and Spearman rank correlation test were performed to examine the relationships between variables. Clinical severity was assessed with the modified Hoehn and Yahr rating scale. Results: The normalized signal ratios in the middle and lateral segments of the substantia nigra were significantly higher in those with CO-induced parkinsonism, compared with those with CO intoxication without parkinsonism or normal volunteers (P = .02). For the medial segments, the ratios showed no significant differences among the groups. The normalized signal ratios of substantia nigra were correlated with the severity of parkinsonism, particularly in the lateral segments (ρ = 0.927, P < .001). Conclusion: CO toxicity to the substantia nigra plays a role in pathophysiologic mechanisms of CO-induced parkinsonism. GM-suppressed IR MR imaging is a useful tool in depicting substantia nigra injury following CO intoxication. ? RSNA, 2012.
SDGs
Other Subjects
carbon monoxide; adult; article; automation; carbon monoxide intoxication; clinical article; controlled study; diagnostic value; disease severity; female; Hoehn and Yahr rating scale; human; informed consent; male; nuclear magnetic resonance imaging; parkinsonism; priority journal; prospective study; rating scale; signal detection; signal noise ratio; substantia nigra; temporal lobe; volunteer; white matter; Adult; Analysis of Variance; Carbon Monoxide Poisoning; Case-Control Studies; Female; Humans; Image Interpretation, Computer-Assisted; Magnetic Resonance Imaging; Male; Parkinsonian Disorders; Prospective Studies; Severity of Illness Index; Statistics, Nonparametric; Substantia Nigra
Type
journal article