Accuracy of MR markers for differentiating Progressive Supranuclear Palsy from Parkinson's disease

Zanigni, Stefano; Calandra-Buonaura, Giovanna; Manners, David Neil; Testa, Claudia; Gibertoni, Dino; Evangelisti, Stefania; Sambati, Luisa; Guarino, Maria; Massis, Patrizia De; Gramegna, Laura Ludovica; Bianchini, Claudio; Rucci, Paola; Cortelli, Pietro; Lodi, Raffaele; Tonon, Caterina

doi:10.1016/j.nicl.2016.05.016

Cited by 53 publications

(73 citation statements)

References 31 publications

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“…7, 8, 35, 39 Whereas most studies report increased MD values in the PUT of PSP patients. 35, 39, 40 we did not detect MD changes in the PUT or other basal ganglia structures (CN and GP) in the current study. Consistent with our findings, Tsukamoto et al reported no MD changes in the PUT of PSP patients.…”

Section: Discussioncontrasting

confidence: 79%

Combined Diffusion Tensor Imaging and Apparent Transverse Relaxation Rate Differentiate Parkinson Disease and Atypical Parkinsonism

Du¹,

Lewis²,

Kanekar³

et al. 2017

AJNR Am J Neuroradiol

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Background and Purpose Both diffusion tensor imaging (DTI) and R2* have shown promise in differentiating Parkinson’s disease (PD) from atypical parkinsonism [particularly multiple system atrophy (MSA) and progressive supranuclear palsy (PSP)]. We assessed DTI, R2*, and their combination for differentiating PD, MSA, PSP, and controls. Materials and Methods A total of 106 subjects (36 controls, 35 PD, 16 MSA, and 19 PSP) were included. DTI and R2* measures from striatal, midbrain, limbic, and cerebellar regions were obtained and compared between groups. The discrimination performance of DTI and R2* among groups was assessed using elastic-net machine learning and receiver operating characteristic analysis. Results Compared to controls, PD patients showed significant R2* differences in the red nucleus. Compared to PD, both MSA and PSP patients showed more widespread changes, extending from the midbrain to striatal and cerebellar structures. The pattern of changes, however, was different between the two groups. For instance, MSA patients showed decreased FA and increased R2* in the subthalamic nucleus, whereas PSP patients showed increased MD in the hippocampus. Combined DTI and R2* were significantly better than DTI or R2* alone in separating controls from PD/MSA-P/PSP, controls from PD, PD from MSA-P/PSP, and PD from MSA-P, but not PD from PSP or MSA-P from PSP. Conclusion DTI and R2* provide different but complementary information for different parkinsonisms. Combined DTI and R2* may be a superior marker for PD differential diagnosis.

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Section: Discussioncontrasting

confidence: 79%

Combined Diffusion Tensor Imaging and Apparent Transverse Relaxation Rate Differentiate Parkinson Disease and Atypical Parkinsonism

Du¹,

Lewis²,

Kanekar³

et al. 2017

AJNR Am J Neuroradiol

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“…Differences among groups in each size measurement. A similar tendency was observed in recent studies 6,20,22. Reduced midbrain length (C) or area (D) in patients with PSP or CBS.…”

supporting

confidence: 88%

“…6,[9][10][11][12][13][14][15][16][17][18][19][20][21][22] However, it takes less time to measure the anteroposterior diameter than the area. 6,[9][10][11][12][13][14][15][16][17][18][19][20][21][22] However, it takes less time to measure the anteroposterior diameter than the area.…”

Section: Introductionmentioning

confidence: 99%

“One line”: A method for differential diagnosis of parkinsonian syndromes

et al. 2019

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Background: Neurological findings are important for the differential diagnosis of Parkinson's disease (PD), multiple system atrophy with predominant parkinsonian features (MSA-P), and progressive supranuclear palsy (PSP). There is currently no fast and reliable method to distinguish these patients. Objectives:To address this, we propose a novel approach to measure midbrain and pons size using a longitudinal "one line" method from the mid-sagittal view.Methods: Structural images were acquired from 101 subjects who underwent 3.0 T MRI (20 controls, 44 PD, 20 MSA, 12 PSP, and 5 corticobasal syndrome). We measured the middle cerebellar peduncle (MCP), superior cerebellar peduncle (SCP), midbrain, and pons. Brainstem size was measured by area or length of the longitudinal axis, which we named the "one line" method. We conducted intraclass correlation coefficients to assess the extent of agreement and consistency among raters, and receiver operating characteristic curves were used to determine diagnostic accuracy.Results: Intraclass correlation coefficients (ICC) of MCP width were excellent in sagittal and axial sections while those of SCP width were moderate. There were also excellent ICCs between raters for "one line" method of the midbrain and pons, while areas showed good ICCs. "One line" method and area of the midbrain were better than SCP width for the differential diagnosis of PSP from MSA-P and PD. In contrast, there was no clearly superior measurement for differentially diagnosing MSA-P. Conclusions:The "one line" method was comparable with area for inter-rater agreement and diagnostic accuracy even though this was a simple and fast way. K E Y W O R D Sbrainstem, magnetic resonance imaging, multiple system atrophy, Parkinson's disease, progressive supranuclear palsy S U PP O RTI N G I N FO R M ATI O NAdditional supporting information may be found online in the Supporting Information section at the end of the article.How to cite this article: Sako W, Abe T, Haji S, et al. "One line": A method for differential diagnosis of parkinsonian syndromes.

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“…In the past few years, MRPI has been widely proposed to support clinicians in the difficult task of differentiating clinically patients with PSP from those with PD or those with other parkinsonisms . A recent study from the MDS‐endorsed group for PSP stated that the P/M and MRPI were the most reliable biomarkers for diagnosing PSP‐RS both in the early and late stages of the disease.…”

Section: Discussionmentioning

confidence: 99%

“…Magnetic resonance (MR) imaging measurements have been shown to be useful for diagnosing PSP . The MR Parkinsonism Index (MRPI) has proven to be an accurate biomarker for diagnosing patients with PSP and for predicting the clinical evolution toward PSP phenotypes of patients affected by undetermined parkinsonism or the appearance of vertical supranuclear gaze palsy (VSGP) in patients with PSP‐P . Overall, this biomarker is highly accurate in diagnosing PSP‐RS but shows a low sensitivity in distinguishing between patients with PSP‐P and those with PD .…”

mentioning

confidence: 99%

Refining initial diagnosis of Parkinson's disease after follow‐up: A 4‐year prospective clinical and magnetic resonance imaging study

Quattrone

Morelli

Vescio³

et al. 2019

Movement Disorders

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Background No prospective study of patients with Parkinson's disease (PD) has investigated the appearance of vertical gaze abnormalities, a feature suggestive of progressive supranuclear palsy (PSP). Objective To identify, within a cohort of patients with an initial diagnosis of PD, those who developed vertical gaze abnormalities during a 4‐year follow‐up, and to investigate the performance of new imaging biomarkers in predicting vertical gaze abnormalities. Methods A total of 110 patients initially classified as PD and 74 controls were enrolled. All patients underwent clinical assessment at baseline and every year up to the end of the follow‐up. The pons/midbrain area ratio 2.0 and the Magnetic Resonance Parkinsonism Index 2.0 were calculated. Results After 4‐year follow‐up, 100 of 110 patients maintained the diagnosis of PD, whereas 10 PD patients (9.1%) developed vertical gaze abnormalities, suggesting an alternative diagnosis of PSP‐parkinsonism. At baseline, the Magnetic Resonance Parkinsonism Index 2.0 was the most accurate biomarker in differentiating PD patients who developed vertical gaze abnormalities from those who maintained an initial diagnosis of PD. At the end of follow‐up, both of these biomarkers accurately distinguished PSP‐parkinsonism from PD. Conclusions Our results demonstrate that a number of patients with an initial diagnosis of PD developed vertical gaze abnormalities during a 4‐year follow‐up, and the diagnosis was changed from PD to PSP‐parkinsonism. In PD patients, baseline Magnetic Resonance Parkinsonism Index 2.0 showed the best performance in predicting the clinical evolution toward a PSP‐parkinsonism phenotype, enabling PSP‐parkinsonism patients to be identified at the earliest stage of the disease for promising disease‐modifying therapies. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

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Accuracy of MR markers for differentiating Progressive Supranuclear Palsy from Parkinson's disease

Cited by 53 publications

References 31 publications

Combined Diffusion Tensor Imaging and Apparent Transverse Relaxation Rate Differentiate Parkinson Disease and Atypical Parkinsonism

Combined Diffusion Tensor Imaging and Apparent Transverse Relaxation Rate Differentiate Parkinson Disease and Atypical Parkinsonism

“One line”: A method for differential diagnosis of parkinsonian syndromes

Refining initial diagnosis of Parkinson's disease after follow‐up: A 4‐year prospective clinical and magnetic resonance imaging study

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