AJDRAJNR - American Journal of Neuroradiology

Published ahead of print on December 12, 2008
doi: 10.3174/ajnr.A1390

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BRAIN

Voxel-Based Morphometry in Individual Patients: A Pilot Study in Early Huntington Disease

M. Mühlaua, A.M. Wohlschlägera,b,c, C. Gaserd, M. Valeta, A. Weindla, S. Nunnemanna, A. Peinemanna, T. Etgena and R. Ilga

a Departments of Neurology, Technische Universität München, Munich, Germany
b Nuclear Medicine, Technische Universität München, Munich, Germany
c Neuroradiology, Technische Universität München, Munich, Germany
d Department of Psychiatry, University of Jena, Jena, Germany

Please address correspondence to Mark Mühlau, MD, Department of Neurology, Technische Universität München, Ismaninger Str 22, 81675 Munich, Germany; e-mail: muehlau{at}lrz.tum.de

BACKGROUND AND PURPOSE: Voxel-based morphometry (VBM) has proved a powerful method to detect subtle changes of gray matter (GM) at the group level but the role of VBM for the detection of GM changes in single subjects, especially in those with suspected neurodegenerative disorder, remains uncertain. Here, we performed single subject analyses in 22 patients in early stages of Huntington disease (HD), a neurodegenerative disorder with a well-known and characteristic pattern of GM loss.

MATERIALS AND METHODS: We applied an ANCOVA with age and gender as covariates and corrected for multiple statistical tests by false discovery rate (P < 0.05). Each patient was compared to 133 healthy controls. The same procedure was applied to 22 of the controls matched for age and gender in a pair-wise manner.

RESULTS: Our analyses yielded biologically plausible results in HD patients in which GM decrease within the caudate nucleus could be identified in 15 of the 16 most affected patients while GM decrease was found in only 1 control subject. Lowering the size of the control group yielded comparable results with 99 and 66 control subjects whereas sensitivity decreased with 33 control subjects.

CONCLUSIONS: Our pilot study demonstrates a potential role of VBM for the detection of cerebral GM changes in single subjects with suspected neurodegenerative disorder.