Characterization and diagnostic potential of R2* in early-stage progressive supranuclear palsy variants

Beliveau, Vincent; Müller, Christoph; Steiger, Ruth; Gizewski, Elke R.; Poewe, Werner; Seppi, Klaus; Scherfler, Christoph

doi:10.1016/j.parkreldis.2022.06.021

Cited by 8 publications

(10 citation statements)

References 35 publications

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“…1). Consistent with this hypothesis is the finding that abnormalities on DAT in the striatum [39], and iron deposition in subcortical structures [23], are similar across PSP variants. Diffusion imaging studies have demonstrated that the superior cerebellar peduncles and dentatorubrothalamic tract are abnormal in PSP-RS, PSP-parkinsonism and PSP-speech/language variants, although show greatest abnormalities in PSP-RS, while PSP-speech/language shows greater involvement of supratentorial white matter tracts [40,41].…”

Section: Understanding Clinical and Anatomical Heterogeneitymentioning

confidence: 69%

“…Neuroimaging techniques measuring different biological targets in subcortical structures could have diagnostic utility in 4R tauopathies. Quantitative susceptibility mapping (QSM) or R2 Ã imaging to measure iron deposition show elevated signal throughout subcortical, brainstem and cerebellar nuclei in PSP-RS [22,23], with uptake in the red nucleus showing the best differentiation from PD (AUROC ¼ 0.83) [22]. However, iron measurements do not outperform brainstem MRI measures [24].…”

Section: Investigating Subcortical Brain Systemsmentioning

confidence: 99%

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Clinical and neuroimaging features of the progressive supranuclear palsy- corticobasal degeneration continuum

Whitwell

2023

Current Opinion in Neurology

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Purpose of review The aim of this study was to discuss how recent work has increased our understanding of progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). The investigation of large and autopsy-confirmed cohorts, imaging modalities to assess different aspects of pathophysiology, clinical phenotypes and the application of advanced machine learning techniques, have led to recent advances in the field that will be discussed. Recent findings Literature over the past 18 months will be discussed under the following themes: studies assessing how different neuroimaging modalities can improve the diagnosis of PSP and CBD from other neurodegenerative and parkinsonian disorders, including the investigation of pathological targets such as tau, iron, neuromelanin and dopamine and cholinergic systems; work improving our understanding of clinical, neuroanatomical and pathological heterogeneity in PSP and CBD; and work using advanced neuroimaging tools to investigate patterns of disease spread, as well as biological mechanisms potentially driving spread through the brain in PSP and CBD. Summary The findings help improve the imaging-based diagnosis of PSP and CBD, allow more targeted prognostic estimates for patients accounting for phenotype or disease, and will aid in the development of appropriate and better-targeted disease biomarkers for clinical treatment trials.

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Section: Understanding Clinical and Anatomical Heterogeneitymentioning

confidence: 69%

Section: Investigating Subcortical Brain Systemsmentioning

confidence: 99%

Clinical and neuroimaging features of the progressive supranuclear palsy- corticobasal degeneration continuum

Whitwell

2023

Current Opinion in Neurology

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“…The hypoperfusion of the frontal lobe was also described, but lacked discrimination of crucial regions [ 6 ]. Other work describing PSP-P and MSA-P showed increased iron accumulation in subcortical nuclei of the brain in both diseases [ 19 ].…”

Section: Discussionmentioning

confidence: 92%

The Assessment of Subregions in the Frontal Lobe May Be Feasible in the Differential Diagnosis of Progressive Supranuclear Palsy—Parkinsonism Predominant (PSP-P) and Multiple System Atrophy (MSA)

et al. 2022

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Progressive Supranuclear Palsy—Parkinsonism Predominant (PSP-P) is associated with moderate responsiveness to levodopa treatment and a possible lack of typical PSP milestones. The clinical manifestation of PSP-P poses difficulties in neurological examination. In the early stages it is often misdiagnosed as Parkinson’s Disease, and in the more advanced stages PSP-P shows more symptoms in common with Multiple System Atrophy—Parkinsonian type (MSA-P). The small number of tools enabling differential diagnosis of PSP-P and MSA leads to the necessity of searching for parameters facilitating in vivo diagnosis. In this study, 14 patients with PSP-P and 21 patients with MSA-P were evaluated using Single Photon Emission Computed Tomography. Considering the fact that PSP is linked with frontal deficits, regions of the frontal lobe were assessed in the context of hypoperfusion and their possible usefulness in the differential diagnosis with MSA-P. The outcome of the work revealed that the right middle frontal gyrus was the region most significantly affected in PSP-P.

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“…In a paper evaluating iron accumulation in MRI in atypical parkinsonisms using R2* MRI it was found that significant differences in the red nucleus and the substantia nigra can be observed between PD, PSP, MSA and healthy controls, but not between PSP-RS and PSP-P. The authors did not perform an extended analysis of the differentiation of MSA and PSP-P [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

The Use of Cerebellar Hypoperfusion Assessment in the Differential Diagnosis of Multiple System Atrophy with Parkinsonism and Progressive Supranuclear Palsy-Parkinsonism Predominant

et al. 2022

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The differential diagnosis of MSA-P and PSP-P remains a difficult issue in clinical practice due to their overlapping clinical manifestation and the lack of tools enabling a definite diagnosis ante-mortem. This paper describes the usefulness of SPECT HMPAO in MSA-P and PSP-P differentiation through the analysis of cerebellar perfusion of small ROIs. Thirty-one patients were included in the study—20 with MSA-P and 11 with PSP-P; the analysis performed indicated that the most significant difference in perfusion was observed in the anterior quadrangular lobule (H IV and V) on the left side (p < 0.0026). High differences in the median perfusion between the groups were also observed in a few other regions, with p < 0.05, but higher than premised p = 0.0026 (the Bonferroni correction was used in the statistical analysis). The assessment of the perfusion may be interpreted as a promising method of additional examination of atypical parkinsonisms with overlapping clinical manifestation, as in the case of PSP-P and MSA-P. The results obtained suggest that the interpretation of the differences in perfusion of the cerebellum should be made by evaluating the subregions of the cerebellum rather than the hemispheres. Further research is required.

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Characterization and diagnostic potential of R2* in early-stage progressive supranuclear palsy variants

Cited by 8 publications

References 35 publications

Clinical and neuroimaging features of the progressive supranuclear palsy- corticobasal degeneration continuum

Clinical and neuroimaging features of the progressive supranuclear palsy- corticobasal degeneration continuum

The Assessment of Subregions in the Frontal Lobe May Be Feasible in the Differential Diagnosis of Progressive Supranuclear Palsy—Parkinsonism Predominant (PSP-P) and Multiple System Atrophy (MSA)

The Use of Cerebellar Hypoperfusion Assessment in the Differential Diagnosis of Multiple System Atrophy with Parkinsonism and Progressive Supranuclear Palsy-Parkinsonism Predominant

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