Changes in Cerebral Gray and White Matter in Patients with Pantothenate Kinase-Associated Neurodegeneration: A Long-Term Magnetic Resonance Imaging Follow-Up Study

• Main Authors: Pedro Roa-Sanchez, Pamela Bido, Jairo Oviedo, Hans-Jürgen Huppertz, Herwin Speckter, Peter Stoeter
• Format: Article
• Language: English
• Published: Korean Movement Disorders Society 2021-05-01
• Series: Journal of Movement Disorders
• Subjects: cerebral gray and white matter volume; long-term follow-up; pantothenate kinase-associated neurodegeneration
• Online Access: http://www.e-jmd.org/upload/jmd-20102.pdf

Objective To determine the volume changes in gray and white matter during a long-term follow-up in patients suffering from pantothenate kinase-associated neurodegeneration (PKAN). Methods Magnetic resonance imaging was repeated in 13 patients and 14 age-matched controls after a mean interval of more than 7 years. T1-weighted sequences were evaluated by fully automated atlas-based volumetry, compared between groups and correlated with disease progression. Results The patients did not show generalized cerebral atrophy but did show a significantly faster volume reduction in the globus pallidus during follow-up (between -0.96% and -1.02% per year, p < 0.05 adjusted for false discovery rate) than controls, which was significantly related to the progression in their dystonia scores (p = 0.032). Conclusion The volume loss in the globus pallidus over time—together with the accumulation of iron known as the “tiger’s eye”—supports the pathophysiologic concept of this nucleus as a center of inhibition and its severe malfunction in PKAN.