Diagnostic accuracy of Magnetic Resonance Parkinsonism Index in differentiating progressive supranuclear palsy from Parkinson's disease and controls in Indian patients

Sankhla, Charulata Savant; Patil, Kirti B; Sawant, Neha; Gupta, Santosh

doi:10.4103/0028-3886.177611

Cited by 24 publications

(57 citation statements)

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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 .…”

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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: 99%

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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“…In this study an MRPI cutoff score of ≥13.625 was used . Other studies that identified a similar sensitivity and specificity have used MRPI cutoffs ranging from ≥12.4 to ≥13.58 …”

Section: Resultsmentioning

confidence: 97%

“…Other measures were used to distinguish PSP in seven studies . There were 13 studies which reported MRI findings with ≥95% sensitivity and specificity for PSP (see Table ) . Of the 70 studies identified, only four studies determined the specificity/sensitivity of a MRI feature for predicting a pathological diagnosis of PSP (see Table ) …”

Section: Resultsmentioning

confidence: 99%

Specificity and sensitivity of magnetic resonance imaging findings in the diagnosis of progressive supranuclear palsy

2017

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Progressive supranuclear palsy (PSP) is a neurodegenerative condition that can only be diagnosed conclusively on pathological examination. Currently, the diagnosis is based upon the National Institute of Neurological Disorders and Stroke and the Society for PSP criteria. These criteria consist of purely clinical findings. Elements of brain MRI that are being investigated for this role include identifying structural features on conventional MRI, volume changes, signal abnormalities and diffusion changes. The aim of this study is to conduct a systematic search to identify which MRI findings have evidence to support their sensitivity/specificity/accuracy in the diagnosis of PSP. A search was conducted of Pubmed and Medline on July 5th-6th 2016 using the medical subject headings progressive supranuclear palsy and MRI. Seventy articles were identified which assessed the sensitivity/specificity/accuracy of MRI signs for the diagnosis of PSP. There were 13 studies that identified MRI features that had ≥95% sensitivity and specificity for the diagnosis of PSP. Four of these studies identified the magnetic resonance parkinsonism index as highly sensitive and specific. There were only four studies which assessed how effective given MRI features are at predicting the pathological diagnosis of PSP. Several markers, such as the magnetic resonance parkinsonism index, have been demonstrated to be both specific and sensitive for PSP. However, many studies assessing these markers have common weaknesses including small sample size and lacking autopsy correlation.

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“…These findings are at variance with several previous studies reporting better performances of some measurements, such as midbrain/pons ratio and MRPI, in distinguishing patients with PSP from those with MSA and PD. In the last few years, many studies evaluated the midbrain/pons ratio and MRPI for differentiating patients with PSP from those with PD showing a high sensitivity and specificity (>85 and up to 100%) …”

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confidence: 99%

MRI measures of brainstem in Parkinsonian syndromes: Where we stand and where we need to go

Quattrone

Nigro

2017

Movement Disorders

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Diagnostic accuracy of Magnetic Resonance Parkinsonism Index in differentiating progressive supranuclear palsy from Parkinson's disease and controls in Indian patients

Abstract: Magnetic Resonance Parkinsonism Index is more sensitive, specific, and accurate in differentiating PSP from PD in the early stages on an individual basis.

Cited by 24 publications

References 0 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

Specificity and sensitivity of magnetic resonance imaging findings in the diagnosis of progressive supranuclear palsy

MRI measures of brainstem in Parkinsonian syndromes: Where we stand and where we need to go

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