Cerebral Peduncle Angle: An Objective Criterion for Assessing Progressive Supranuclear Palsy Richardson Syndrome

Fatterpekar, Girish M.; Dietrich, August; Pantano, P.; Saba, Luca; Knopp, Edmond A.; Piattella, Maria Cristina; Raz, Eytan

doi:10.2214/ajr.14.12724

Cited by 10 publications

(13 citation statements)

References 30 publications

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“…All of our study subjects had pathologically confirmed disease, and the number of subjects was larger than that of the Fatterpekar et al (PSP-RS, n=15; MSA, n=15; PD, n=22) [22]; however, we could not verify the utility of the CPA measurement for differentiating PSP from other neurodegenerative diseases. Although atrophy occurs in the tegmentum of the midbrain and the superior cerebellar peduncles in PSP patients [4, 5], it is unclear if the CPA widens as atrophy progresses.…”

Section: Discussionmentioning

confidence: 72%

“…Fatterpekar et al reformatted and standardized T1-weighted axial images along the anterior commissure-posterior commissure line [22]. To maximize external validity, we used unstandardized axial MRI images on several sequences; however, the less stringent image criteria allowed differences in axial plane level and subsequently cerebral peduncular contour heterogeneity.…”

Section: Discussionmentioning

confidence: 99%

“…Fatterpekar and colleagues quantified midbrain atrophy by calculating an angle between the cerebral peduncles on magnetic resonance imaging (MRI). They showed the cerebral peduncle angle (CPA) to be significantly larger in clinically diagnosed PSP-Richardson Syndrome (PSP-RS) patients compared to MSA patients and PD patients and healthy controls [22]. Their study included patients diagnosed with MSA and PD according to Gilman et al and Gelb et al, respectively [23, 24].…”

Section: Introductionmentioning

confidence: 99%

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Cerebral peduncle angle: Unreliable in differentiating progressive supranuclear palsy from other neurodegenerative diseases

Tipton

Konno

Broderick

et al. 2016

Parkinsonism & Related Disorders

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Introduction The significant symptom overlap between progressive supranuclear palsy (PSP) and other parkinsonian neurodegenerative diseases frequently results in misdiagnosis. However, neuroimaging can be used to quantify disease-related morphological changes and specific markers. The cerebral peduncle angle (CPA) has been shown to differentiate clinically diagnosed PSP from other parkinsonian diseases but this result has yet to be confirmed in autopsy-proven disease. Methods Magnetic resonance imaging (MRI) scans were obtained for 168 patients representing 69 medical facilities. Following randomization, the images were divided into two groups (Type 1 and Type 2) based upon midbrain morphological differences. Two readers were blinded and independently measured the CPA of 146 patients with autopsy-proven progressive supranuclear palsy (PSP; n=54), corticobasal degeneration (n=16), multiple system atrophy (MSA; n=11) and Lewy body disease (n=65). Results Applying two separate measurement techniques revealed no statistically significant differences in CPA measurements among any study groups regardless of classification measurement approach. The interobserver agreement showed significant differences in measurements using the Type 2 approach. Conclusion Measuring the CPA on MRI is not a reliable way of differentiating among patients with PSP, corticobasal degeneration, MSA, or Lewy body disease.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cerebral peduncle angle: Unreliable in differentiating progressive supranuclear palsy from other neurodegenerative diseases

Tipton

Konno

Broderick

et al. 2016

Parkinsonism & Related Disorders

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“…21,22 Los índices bicaudado, de Evans y bifrontal se obtienen en cortes axiales de TC y RM con orientación orbito-meatal, utilizándose para mesurar el envejecimiento fisiológico y cuantificar el grado de atrofia cerebral (►Tablas 2-4). [22][23][24] Fig. 1 Medición de hematoma.…”

Section: Valoración De La Atrofia Encefálicaunclassified

“…[22][23][24] Un valor > a 0,30 indica ventriculomegalia y puede considerarse patológico, pero no puede discriminarse la etiología por atrofia u otra entidad. [22][23][24] C) Índice bifrontal: se calcula dividiendo el diámetro máximo de las astas frontales de los ventrículos laterales y el diámetro intracraneal a ese mismo nivel (►Fig. 6).…”

Section: Valoración De La Atrofia Encefálicaunclassified

Mediciones frecuentes en el sistema nervioso central mediante tomografía computada e imágenes de resonancia magnética

Sartori¹,

Alvarado²,

Chirveches³

et al. 2020

Rev Argent Radiol

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ResumenEn la práctica diaria, durante la realización de informes, suelen presentarse variantes anatómicas, lesiones y diversas patologías del sistema nervioso central (SNC) en las que es necesario realizar algún tipo de mediciones con la finalidad de formular un diagnóstico preciso.Esas mediciones permiten al médico derivante o tratante programar y realizar procedimientos terapéuticos mínimamente invasivos o que requieran una intervención quirúrgica de mayor relevancia.Realizamos una descripción de las mediciones más frecuentes en el SNC empleando tomografía computada (TC) e imágenes de resonancia magnética (RM).

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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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Cerebral Peduncle Angle: An Objective Criterion for Assessing Progressive Supranuclear Palsy Richardson Syndrome

Abstract: The cerebral peduncle angle is a simple, easy-to-calculate, and reproducible measure of midbrain atrophy. It is a useful criterion for differentiating patients with PSP-RS from healthy persons and from patients with multiple-system atrophy or Parkinson disease.

Cited by 10 publications

References 30 publications

Cerebral peduncle angle: Unreliable in differentiating progressive supranuclear palsy from other neurodegenerative diseases

Cerebral peduncle angle: Unreliable in differentiating progressive supranuclear palsy from other neurodegenerative diseases

Mediciones frecuentes en el sistema nervioso central mediante tomografía computada e imágenes de resonancia magnética

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

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