Purpose: To evaluate the effect of levodopa on apparent diffusion coefficient (ADC) value of the brain parenchyma in patients with idiopathic Parkinson disease (PD).

Material And Methods: Prospective study was conducted on native PD without treatment (n = 25) and patients receiving levodopa (L-Dopa) (n = 25). Diffusion magnetic resonance-weighted imaging was done using a single-shot spin echo type of echo planar imaging. The apparent diffusion coefficient (ADC) value at different regions of the brain on both sides was calculated.

Results: The ADC value of the putamen in patients with native PD was 0.732 ± 0.15 × 10-3 mm2/seconds and in patients receiving levodopa was 0.789 ± 0.24 × 10-3 mm2/second. There was a statistically significant difference in the ADC value at the putamen (P = .001) between patients with native PD and patients receiving levodopa. When ADC value of the putamen at 0.745 × 10-3 mm2/second was used as a threshold value for differentiating native PD patients and patients receiving L-Dopa, the best results were obtained with an accuracy of 82%, sensitivity of 92%, specificity of 72%, positive predictive value of 77%, negative predictive value of 90%, and area under the curve of 0.955.

Conclusion: ADC value of the putamen is a promising parameter for predication of effect of levodopa on brain parenchyma in patients with PD.

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http://dx.doi.org/10.1016/j.acra.2010.08.023DOI Listing

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