{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T23:11:30Z","timestamp":1789168290672,"version":"build-2803163510"},"reference-count":45,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2020,2,28]],"date-time":"2020-02-28T00:00:00Z","timestamp":1582848000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Science and Technology Taiwan, Healthy Aging Research Center, Chang Gung Memorial Hospital","award":["MOST 106-2314-B-182 -018 -MY3, MOST 106-2911-I-182-505, MOST 107-2911-I-182-503, EMRPD1H0411, EMRPD1H0551, EMRPD1H0431, EMRPD1I0501, EMRPD1I0471, CMRPD1G0561-2, and CMRPG2B0251"],"award-info":[{"award-number":["MOST 106-2314-B-182 -018 -MY3, MOST 106-2911-I-182-505, MOST 107-2911-I-182-503, EMRPD1H0411, EMRPD1H0551, EMRPD1H0431, EMRPD1I0501, EMRPD1I0471, CMRPD1G0561-2, and CMRPG2B0251"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Robust early prediction of clinical outcomes in Parkinson\u2019s disease (PD) is paramount for implementing appropriate management interventions. We propose a method that uses the baseline MRI, measuring diffusion parameters from multiple parcellated brain regions, to predict the 2-year clinical outcome in Parkinson\u2019s disease. Diffusion tensor imaging was obtained from 82 patients (males\/females = 45\/37, mean age: 60.9 \u00b1 7.3 years, baseline and after 23.7 \u00b1 0.7 months) using a 3T MR scanner, which was normalized and parcellated according to the Automated Anatomical Labelling template. All patients were diagnosed with probable Parkinson\u2019s disease by the National Institute of Neurological Disorders and Stroke criteria. Clinical outcome was graded using disease severity (Unified Parkinson\u2019s Disease Rating Scale and Modified Hoehn and Yahr staging), drug administration (levodopa equivalent daily dose), and quality of life (39-item PD Questionnaire). Selection and regularization of diffusion parameters, the mean diffusivity and fractional anisotropy, were performed using least absolute shrinkage and selection operator (LASSO) between baseline diffusion index and clinical outcome over 2 years. Identified features were entered into a stepwise multivariate regression model, followed by a leave-one-out\/5-fold cross validation and additional blind validation using an independent dataset. The predicted Unified Parkinson\u2019s Disease Rating Scale for each individual was consistent with the observed values at blind validation (adjusted R2 0.76) by using 13 features, such as mean diffusivity in lingual, nodule lobule of cerebellum vermis and fractional anisotropy in rolandic operculum, and quadrangular lobule of cerebellum. We conclude that baseline diffusion MRI is potentially capable of predicting 2-year clinical outcomes in patients with Parkinson\u2019s disease on an individual basis.<\/jats:p>","DOI":"10.3390\/jcm9030647","type":"journal-article","created":{"date-parts":[[2020,3,2]],"date-time":"2020-03-02T07:50:53Z","timestamp":1583135453000},"page":"647","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["A Method for the Prediction of Clinical Outcome Using Diffusion Magnetic Resonance Imaging: Application on Parkinson\u2019s Disease"],"prefix":"10.3390","volume":"9","author":[{"given":"Chih-Chien","family":"Tsai","sequence":"first","affiliation":[{"name":"Healthy Aging Research Center, Chang Gung University, Taoyuan 33302, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6841-5366","authenticated-orcid":false,"given":"Yu-Chun","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Taoyuan 33375, Taiwan"},{"name":"Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan 33302, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-Hang","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Taoyuan 33375, Taiwan"},{"name":"Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan 33302, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao-Liang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Taoyuan 33375, Taiwan"},{"name":"Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Keelung City 20401, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jur-Shan","family":"Cheng","sequence":"additional","affiliation":[{"name":"Clinical Informatics and Medical Statistics Research Center, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan"},{"name":"Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung City 20401, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chin-Song","family":"Lu","sequence":"additional","affiliation":[{"name":"Professor Lu Neurological Clinic, Taoyuan 33375, Taiwan"},{"name":"Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taoyuan 33375, Taiwan"},{"name":"Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 33375, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Hsin","family":"Weng","sequence":"additional","affiliation":[{"name":"Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital, Linkou, Taoyuan 33375, Taiwan"},{"name":"Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan 33375, Taiwan"},{"name":"School of Medicine, Chang Gung University, Taoyuan 33302, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung-Han","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan 33302, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po-Yuan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan 33302, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Ming","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Taoyuan 33375, Taiwan"},{"name":"Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan 33302, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiun-Jie","family":"Wang","sequence":"additional","affiliation":[{"name":"Healthy Aging Research Center, Chang Gung University, Taoyuan 33302, Taiwan"},{"name":"Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan 33302, Taiwan"},{"name":"Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Keelung City 20401, Taiwan"},{"name":"Medical Imaging Research Center, Institute for Radiological Research, Chang Gung University\/Chang Gung Memorial Hospital, Linkou 33375, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,2,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1002\/mds.10459","article-title":"Movement Disorders Society Scientific Issues, Movement Disorders Society Scientific Issues Committee report: SIC Task Force appraisal of clinical diagnostic criteria for Parkinsonian disorders","volume":"18","author":"Litvan","year":"2003","journal-title":"Mov. 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