Publication date: Jan 15, 2020
Chorea-acanthocytosis is clinically difficult to distinguish from Huntington’s disease because these disorders have similar symptoms and MR imaging findings. We evaluated the usefulness of single-case voxel-based morphometry (VBM) analysis for differentiating the two diseases as well as VBM analysis.
We examined five genetically proven chorea-acanthocytosis patients and 11 Huntington’s disease patients to detect differences in the gray and white matter atrophic pattern by using single-case VBM analysis in each patient and their clinical findings. We also evaluated VBM analysis for a group comparison in both disease and control groups.
The single-case VBM analysis results demonstrated a gray matter volume loss in caudate nucleus in all 16 patients. A characteristic symmetrical white matter volume loss was detected in globus pallidus, putamen, and thalamus on both sides in all the chorea-acanthocytosis patients, but this pattern of atrophy was not seen in any of the Huntington’s disease patients. With the VBM analysis, a significant gray matter volume loss was noted in caudate nucleus on both sides in chorea-acanthocytosis patients compared with Huntington’s disease patients, and a more extensive white matter volume loss around the basal ganglia and thalamus was observed in chorea-acanthocytosis patients compared to Huntington’s disease patients, consistent with the single-case VBM analysis results. Genetic testing identified two novel pathogenic mutations, exon 1 c.16_22delGTGGTCG and exon 55 c.7736-7739delGAGA in a chorea-acanthocytosis patient.
Single-case VBM analysis may be useful to differentiate chorea-acanthocytosis from Huntington’s disease with a focus on white matter atrophy.
Suzuki, F., Sato, N., Ota, M., Sugiyama, A., Shigemoto, Y., Morimoto, E., Kimura, Y., Wakasugi, N., Takahashi, Y., Futamura, A., Kawamura, M., Ono, K., Nakamura, M., Sano, A., Watanabe, M., Matsuda, H., and Abe, O. Discriminating chorea-acanthocytosis from Huntington’s disease with single-case voxel-based morphometry analysis. 06880. 2020 J Neurol Sci (408):