Intraventricular cerebrospinal fluid temperature analysis using MR diffusion-weighted imaging thermometry in Parkinson's disease patients, multiple system atrophy patients, and healthy subjects

Purpose: We examined the temperature of the intraventricular cerebrospinal fluid (T-v) in patients with Parkinson's disease (PD) and those with multiple system atrophy (MSA) in comparison with healthy subjects, and we examined normal changes in this temperature with aging. Methods: T-v was estimated by magnetic resonance (MR) diffusion-weighted imaging (DWI) thermometry in 36 PD patients (19 males, 17 females), 34 MSA patients (17 males, 17 females), 64 age-matched controls (27 men, 37 women), and 114 all-age adult controls (47 men, 67 women; 28-89years old). The volume of lateral ventricles was also estimated using FreeSurfer in all subjects. T-v and ventricular volume data were compared among the PD and MSA patients and age-matched controls. We also evaluated the relationship between T-v and age in the 114 all-age controls, controlling for ventricular volume. Men and women were analyzed separately. Results: The male PD and MSA patients had significantly higher T-v values compared to the male controls, with no significant difference in ventricular volume among them. There was no significant difference in T-v between the female patients and controls. In the all-age male controls, there was a significant negative correlation between T-v and age controlling for ventricular volume, and this was not observed in the women. Conclusion: DWI thermometry is a useful and easy method for demonstrating an altered intracranial environment in male patients and healthy controls, but not in females. DWI thermometry can thus be used to help to explore the pathophysiology of Parkinsonian syndromes and to differentiate individuals affected by neurodegenerative disease with autonomic dysfunction from those without it.