A new MR imaging index for differentiation of progressive supranuclear palsy-parkinsonism from Parkinson's disease

Quattrone, Aldo; Morelli, Maurizio; Nigro, S. Ló; Quattrone, Andrea; Vescio, Basilio; Arabia, Gennarina; Nicoletti, Giuseppe; Nisticò, Rita; Salsone, Maria; Novellino, Fabiana; Barbagallo, Gaetano; Piane, Emilio Le; Pugliese, Pierfrancesco; Bosco, Domenico; Vaccaro, Maria Grazia; Chiriaco, Carmelina; Sabatini, Umberto; Vescio, Virginia; Stanà, C; Rocca, Federico; Gullà, Domenico; Caracciolo, Manuela

doi:10.1016/j.parkreldis.2018.07.016

Cited by 111 publications

(189 citation statements)

References 29 publications

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“…To date, only a few studies have focused on evaluating the accuracy of MRPI for differentiation of patients with PSP‐P from those with PD . Some authors reported a low sensitivity of this biomarker in differentiating PSP‐P from PD, a finding confirmed by a study in a larger cohort of PSP‐P patients .…”

Section: Discussionmentioning

confidence: 95%

“…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%

“…Some authors reported a low sensitivity of this biomarker in differentiating PSP‐P from PD, a finding confirmed by a study in a larger cohort of PSP‐P patients . Recently, we demonstrated that a new version of MRPI (MRPI 2.0) was highly accurate in differentiating patients with PSP‐P from those with PD and controls . This version included the measurement of the 3rdV width in the calculation, a brain structure that has been reported to be enlarged in patients with PSP …”

Section: Discussionmentioning

confidence: 99%

“…The new version of these biomarkers (P/M 2.0 and MRPI 2.0), which included the measurement of third ventricle (3rdV) width, was calculated according to the procedure described in a recent study and reported in the supplementary materials.…”

Section: Methodsmentioning

confidence: 99%

“…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 . Recently, we demonstrated that a new version of MRPI that included the measurement of third ventricle width (MRPI 2.0) was highly accurate in differentiating PSP‐P patients from PD . To date, to our knowledge, no prospective study has investigated in vivo the appearance of clinical features of PSP‐P in patients initially diagnosed as PD.…”

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confidence: 99%

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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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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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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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Conventional Magnetic Resonance Imaging in the Diagnosis of Parkinsonian Disorders: AMeta‐Analysis

Lee

2020

Movement Disord Clin Pract

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Background Numerous conventional magnetic resonance imaging (cMRI) parameters were previously found to differentiate parkinsonian disorders with statistical significance, but effect size has not been considered. Objectives To quantify effect size of previously identified cMRI parameters that differentiated parkinsonian disorders with statistical significance. Method A PubMed search limited to studies assessing cMRI parameters in at least 2 of Parkinson's disease, progressive supranuclear palsy, multiple system atrophy, and corticobasal degeneration/syndrome were selected. Either Cohen's d or positive and negative likelihood (LR+/−) as well as diagnostic odds ratios (DORs) were calculated as appropriate. cMRI parameter was considered useful if Cohen's d > 1.94 (<20% overlap) or if LR+ > 10, LR− < 0.1, or DOR > 20. Results Literature search identified 8848 publications and 36 were included for analysis. Putaminal (Cohen's d 2.07; DOR 23–infinity), pontine (DOR 32–infinity), and middle cerebellar peduncle (Cohen's d 2.24; DOR infinity) abnormalities were most useful in differentiating multiple system atrophy while reduced midbrain (Cohen's d 2.33–8.69; DOR infinity) and superior cerebellar peduncle (Cohen's d 2.47; DOR 51–infinity) diameters separated progressive supranuclear palsy. Corticobasal degeneration/syndrome does not have any distinguishing cMRI features, but reduced midbrain diameter may help differentiate corticobasal degeneration/syndrome from Parkinson's disease (DOR infinity). When LR− was calculated, all of these features carried a value of <0.1. Conclusion A number of cMRI features consistently demonstrated large effect size in separating parkinsonian disorders. However, it is the presence and not absence of these cMRI features that is most useful in patients with low to moderate pretest probability.

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Diagnostic Performance of Putaminal Hypointensity on Susceptibility MRI in Distinguishing Parkinson Disease from Progressive Supranuclear Palsy: A Meta‐Analysis

Mao

2022

Movement Disord Clin Pract

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Background Idiopathic Parkinson's disease (IPD) and progressive supranuclear palsy (PSP) have similar clinical signs and symptoms, making accurate clinical diagnosis difficult. T2* gradient echo (T2* GRE), susceptibility‐weighted imaging (SWI), and quantitative susceptibility mapping (QSM) are susceptibility MR imaging sequences that provide more information about brain iron levels than other conventional MR imaging. Objective This study aimed to evaluate the diagnostic power of putaminal hypointensity on T2* GRE, SWI, and QSM in distinguishing PSP from IPD. Methods Eligible studies were identified via systematic searches of PubMed and Clarivate Analytics® Web of Science® Core Collection. Studies that satisfied the inclusion and exclusion criteria were reviewed. A meta‐analysis was conducted using the hierarchical summary receiver operating characteristic curve approach. Results Our literature search of the two databases yielded 562 primary articles, 10 of which were deemed relevant and only six were eligible for further analyses. We performed a meta‐analysis of putaminal hypointensity measurements: 438 patients with IPD and 109 patients with PSP were enrolled in the quantitative synthesis. The meta‐analysis of six studies with 547 patients revealed a sensitivity of 69% (95% confidence interval (CI): 33%–90%) and specificity of 91% (95% CI: 80%–96%) for putaminal hypointensity on T2* GRE, SWI, or QSM distinguishing PSP from IPD. Conclusions Putaminal hypointensity on T2* GRE, SWI, or QSM is able to distinguish patients with PSP from those with IPD with high specificity. Further multicenter prospective studies on patients are needed to verify our results.

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A new MR imaging index for differentiation of progressive supranuclear palsy-parkinsonism from Parkinson's disease

Cited by 111 publications

References 29 publications

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

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

Conventional Magnetic Resonance Imaging in the Diagnosis of Parkinsonian Disorders: AMeta‐Analysis

Diagnostic Performance of Putaminal Hypointensity on Susceptibility MRI in Distinguishing Parkinson Disease from Progressive Supranuclear Palsy: A Meta‐Analysis

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