Connectivity-based segmentation of the substantia nigra in human and its implications in Parkinson's disease

The aims of this study were to i) identify substantia nigra subregions i.e. pars reticulata (SNr) and pars compacta (SNc), in human, and ii) to assess volumetric changes in these subregions in the diagnosis of Parkinson's disease. Current MR imaging techniques are unable to distinguish SNr and SNc. Segmentation of these regions may be clinically useful in Parkinson's disease (PD) as substantia nigra is invariably affected in PD. We acquired quantitative T1 as well as diffusion tensor imaging (DTI) data from ten healthy subjects and ten PD patients. For each subject, the left and right SN were manually outlined on T1 images and then classified into two discrete regions based on the characteristics of their connectivity with the rest of the brain using an automated clustering method on the DTI data. We identified two regions in each subjects' SN: an internal region that is likely to correspond with SNc because it was mainly connected with posterior striatum, pallidum, anterior thalamus, and prefrontal cortex; and an external region that corresponds with SNr because it was chiefly connected with posterior thalamus, ventral thalamus, and motor cortex. Volumetric study of these regions in PD patients showed a general atrophy in PD particularly in the right SNr. This pilot study showed that automated DTI-based parcellation of SN subregions may provide a useful tool for in-vivo identification of SNc and SNr and might therefore assist to detect changes that occur in patients with PD.