Cerebral magnetic resonance elastography in supranuclear palsy and idiopathic Parkinson's disease

•We assessed brain viscoelasticity in neurodegenerative disorders by MR-elastography.•Parameters of brain softness and viscosity are reduced in PSP, particularly in the lentiform nucleus.•Reduction of viscoelasticity in Parkinson’s disease is less severe and limited to brain softness.•Reduction of brain viscoelasticity is correlated with measures of clinical severity.•Combination of MMRE and 3DMRE is a sensitive tool to quantify regional neurodegeneration.

Detection and discrimination of neurodegenerative Parkinson syndromes are challenging clinical tasks and the use of standard T1- and T2-weighted cerebral magnetic resonance (MR) imaging is limited to exclude symptomatic Parkinsonism. We used a quantitative structural MR-based technique, MR-elastography (MRE), to assess viscoelastic properties of the brain, providing insights into altered tissue architecture in neurodegenerative diseases on a macroscopic level. We measured single-slice multifrequency MRE (MMRE) and three-dimensional MRE (3DMRE) in two neurodegenerative disorders with overlapping clinical presentation but different neuropathology — progressive supranuclear palsy (PSP: N = 16) and idiopathic Parkinson's disease (PD: N = 18) as well as in controls (N = 18). In PSP, both MMRE (Δμ = − 28.8%, Δα = − 4.9%) and 3DMRE (Δ|G*|: − 10.6%, Δφ: − 34.6%) were significantly reduced compared to controls, with a pronounced reduction within the lentiform nucleus (Δμ = − 34.6%, Δα = − 8.1%; Δ|G*|: − 7.8%, Δφ: − 44.8%). MRE in PD showed a comparable pattern, but overall reduction in brain elasticity was less severe reaching significance only in the lentiform nucleus (Δμ n.s., Δα = − 7.4%; Δ|G*|: − 6.9%, Δφ: n.s.). Beyond that, patients showed a close negative correlation between MRE constants and clinical severity. Our data indicate that brain viscoelasticity in PSP and PD is differently affected by the underlying neurodegeneration; whereas in PSP all MRE constants are reduced and changes in brain softness (reduced μ and |G*|) predominate those of viscosity (α and φ) in PD.