{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T03:10:50Z","timestamp":1788577850137,"version":"build-2803163510"},"reference-count":44,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T00:00:00Z","timestamp":1705449600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Grants-in-Aid from the Research Committee of Ataxia, the Health Labor Sciences Research Grant, and the Ministry of Health, Labor and Welfare, Japan","award":["JPMH20FC1041"],"award-info":[{"award-number":["JPMH20FC1041"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Multiple system atrophy with predominant parkinsonism (MSA-P) can hardly be distinguished from Parkinson\u2019s disease (PD) clinically in the early stages. This study investigated whether a standardized T1-weighted\/T2-weighted ratio (sT1w\/T2w ratio) can effectively detect degenerative changes in the middle cerebellar peduncle (MCP) associated with MSA-P and PD and evaluated its potential to distinguish between these two diseases. We included 35 patients with MSA-P, 32 patients with PD, and 17 controls. T1w and T2w scans were acquired using a 1.5-T MR system. The MCP sT1w\/T2w ratio was analyzed via SPM12 using a region-of-interest approach in a normalized space. The diagnostic performance of the MCP sT1w\/T2w ratio was compared between the MSA-P, PD, and controls. Patients with MSA-P had significantly lower MCP sT1w\/T2w ratios than patients with PD and controls. Furthermore, MCP sT1w\/T2w ratios were lower in patients with PD than in the controls. The MCP sT1w\/T2w ratio showed excellent or good accuracy for differentiating MSA-P or PD from the control (area under the curve (AUC) = 0.919 and 0.814, respectively) and substantial power for differentiating MSA-P from PD (AUC = 0.724). Therefore, the MCP sT1w\/T2w ratio is sensitive in detecting degenerative changes in the MCP associated with MSA-P and PD and is useful in distinguishing MSA-P from PD.<\/jats:p>","DOI":"10.3390\/diagnostics14020201","type":"journal-article","created":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T07:41:28Z","timestamp":1705477288000},"page":"201","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Differentiation between Parkinson\u2019s Disease and the Parkinsonian Subtype of Multiple System Atrophy Using the Magnetic Resonance T1w\/T2w Ratio in the Middle Cerebellar Peduncle"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0371-436X","authenticated-orcid":false,"given":"Jiaqi","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0705-9892","authenticated-orcid":false,"given":"Atsuhiko","family":"Sugiyama","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Yokota","sequence":"additional","affiliation":[{"name":"Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeki","family":"Hirano","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4297-6354","authenticated-orcid":false,"given":"Tatsuya","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan"},{"name":"Department of Rehabilitation, Division of Occupational Therapy, Chiba Prefectural University of Health Sciences, Chiba 261-0014, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshitaka","family":"Yamanaka","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan"},{"name":"Urayasu Rehabilitation Education Center, Chiba University Hospital, Urayasu 279-0023, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuyuki","family":"Araki","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3659-6152","authenticated-orcid":false,"given":"Shoichi","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan"},{"name":"Department of Medical Education, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friedemann","family":"Paul","sequence":"additional","affiliation":[{"name":"Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charit\u00e9-Universit\u00e4tsmedizin Berlin, 10117 Berlin, Germany"},{"name":"NeuroCure Clinical Research Center, Charit\u00e9-Universit\u00e4tsmedizin Berlin, 10117 Berlin, Germany"},{"name":"Einstein Center for Neurosciences, Charit\u00e9-Universit\u00e4tsmedizin Berlin, 10117 Berlin, Germany"},{"name":"Department of Neurology, Charit\u00e9-Universit\u00e4tsmedizin Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Kuwabara","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1056\/NEJMra1311488","article-title":"Multiple-system atrophy","volume":"372","author":"Fanciulli","year":"2015","journal-title":"N. 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