Imaging of olfactory bulb and gray matter volumes in brain areas associated with olfactory function in patients with Parkinson's disease and multiple system atrophy

We explored if magnetic resonance imaging sequences might aid in the clinical differential diagnosis of idiopathic Parkinson's disease (IPD) and multiple system atrophy (MSA). We measured the volumes of the olfactory bulb, the olfactory tract, and olfaction-associated cortical gray matter in 20 IPD patients, 14 MSA patients, and 12 normal subjects, using high-resolution magnetic resonance imaging sequences in combination with voxel-based statistical analysis. We found that, compared to normal subjects and MSA patients, the volumes of the olfactory bulb and tract were significantly reduced in IPD patients. The gray matter volume of IPD patients decreased in the following order: the olfactory area to the right of the piriform cortex, the right amygdala, the left entorhinal cortex, and the left occipital lobe. Further, the total olfactory bulb volume of IPD patients was associated with the duration of disease. The entorhinal cortical gray matter volume was negatively associated with the UPDRS III score. Conclusion: Structural volumes measured by high-resolution magnetic resonance imaging may potentially be used for differential diagnosis of IPD from MSA