MRI measurements of brainstem structures in patients with Richardson's syndrome, progressive supranuclear palsy-parkinsonism, and Parkinson's disease

Longoni, Giulia; Kostić, Vladimir; Stojković, Tanja; Pagani, Elisabetta; Stošić-Opinćal, Tatjana; Filippi, Massimo

doi:10.1002/mds.23293

Cited by 118 publications

(123 citation statements)

References 37 publications

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“…The similarity of ROI-measured atrophy rates between PSP and PSP-DAV supports the conclusion that the larger PSP-DAV sample size enabled detection of smaller cortical changes using VBM maps, which indicate statistical significance but not magnitude. In addition, the midbrain to pons ratio, which has previously been shown to be decreased in PSP, [26][27][28][29][30] was nearly identical in the PSP and PSP-DAV groups and smaller than in the CBS or NC group. Future studies of autopsy-confirmed CBD and PSP cases will be necessary to definitively determine the differences in rates of volume loss between these disorders.…”

Section: Magnitude Of Longitudinal Volumetric Changes In Definedmentioning

confidence: 56%

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Progression of brain atrophy in PSP and CBS over 6 months and 1 year

et al. 2016

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Objective: To examine the utility and reliability of volumetric MRI in measuring disease progression in the 4 repeat tauopathies, progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS), to support clinical development of new tau-directed therapeutic agents.Methods: Six-and 12-month changes in regional MRI volumes and PSP Rating Scale scores were examined in 55 patients with PSP and 33 patients with CBS (78% amyloid PET negative) compared to 30 normal controls from a multicenter natural history study. Longitudinal voxelbased morphometric analyses identified patterns of volume loss, and region-of-interest analyses examined rates of volume loss in brainstem (midbrain, pons, superior cerebellar peduncle), cortical, and subcortical regions based on previously validated atlases. Results were compared to those in a replication cohort of 226 patients with PSP with MRI data from the AL-108-231 clinical trial.Results: Patients with CBS exhibited greater baseline atrophy and greater longitudinal atrophy rates in cortical and basal ganglia regions than patients with PSP; however, midbrain and pontine atrophy rates were similar. Voxel-wise analyses showed distinct patterns of regional longitudinal atrophy in each group as compared to normal controls. The midbrain/pons volumetric ratio differed between diagnoses but remained stable over time. In both patient groups, brainstem atrophy rates were correlated with disease progression measured using the PSP Rating Scale.Conclusions: Volume loss is quantifiable over a period of 6 months in CBS and PSP. Future clinical trials may be able to combine CBS and PSP to measure therapeutic effects. Progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) are rare neurodegenerative disorders associated with the accumulation of insoluble deposits of predominantly 4 microtubule binding domain repeat (4R) tau protein in specific brain regions, mainly in the absence of other pathogenic proteins including b-amyloid.1 Accordingly, PSP and CBD are classified as primary 4R tauopathies. There are currently no effective therapies for either disorder, but the development of new therapeutic agents that target the tau protein has led to increased interest in pursuing clinical trials in CBD and PSP, either individually or for a combined 4R tauopathy indication.

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Section: Magnitude Of Longitudinal Volumetric Changes In Definedmentioning

confidence: 56%

“…[26][27][28][29][30] At all time points, both PSP and PSP-DAV groups had lower midbrain to pons ratios than NC and CBS groups (figure e-2). Moreover, midbrain/pons ratios within all groups remained stable over 1 year in all groups.…”

Section: Magnitude Of Longitudinal Volumetric Changes In Definedmentioning

confidence: 96%

Progression of brain atrophy in PSP and CBS over 6 months and 1 year

et al. 2016

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“…In the diagnostic workup, magnetic resonance imaging (MRI) signs of PSP include prominent midbrain and pons atrophy, which have been combined in the conventional MR parkinsonism index [5,6]. Volumetric/morphometric MRI studies have shown frontal atrophy in PSP [7,8] and have demonstrated tissue loss in fronto-/mesiotemporal cortices and prefrontal regions in addition to the central midbrain and basal ganglia [9,10]. …”

Section: Introductionmentioning

confidence: 99%

Frontal Corpus Callosum Alterations in Progressive Supranuclear Palsy but Not in Parkinson's Disease

et al. 2014

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Background: Frontal lobe involvement is considered a clinical and magnetic resonance imaging (MRI) feature in later stages of progressive supranuclear palsy (PSP). Objective: Diffusion tensor imaging (DTI) was used to investigate the integrity of frontal pathways in PSP and Parkinson's disease (PD) patients. Methods: DTI and 3-D MRI were performed in 15 PSP patients (parkinsonism subtype: n = 8; Richardson subtype: n = 7), 15 PD patients, and 18 matched controls. DTI analysis was performed in order to identify differences along frontal white matter structures including the corpus callosum (CC) and was complemented by atlas-based volumetry and planimetry. Results: Significantly reduced regional fractional anisotropy was observed for PSP patients versus controls and PSP versus PD patients, respectively, in frontal areas including the area II of the CC and bilaterally in the callosal radiation. The DTI findings correlated with frontal lobe volumes. These differences were not observed between PD patients and controls. Conclusion: DTI identified a PSP-associated microstructural alteration pattern in the frontal lobes and in the CC area II including the corresponding bilateral callosal radiation tracts that could not be identified in both control samples, supporting the prominent PSP-associated frontal involvement as a potential neuroimaging marker.

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“…On this basis, many studies have been conducted to identify the MRI index that would help differentiate PSP-RS and PSP-P from PD [10,11,12,13,15,21,22,23,24]. In particular, a previous study reported that PSP-P shows atrophy of the midbrain and superior cerebellar peduncles, the characteristic MRI findings of PSP [12,15].…”

Section: Discussionmentioning

confidence: 99%

“…The midbrain area was traced around the edges of line 1 and the midbrain tegmentum above it. The pons included the area between the lines along the anterior and posterior margins of the pons and lines 1 and 2 [10,11,12,13]. The length of the M TEGM was measured on an axial T1-weighted image using the method of Sung et al [14].…”

Section: Methodsmentioning

confidence: 99%

Differential Progression of Midbrain Atrophy in Parkinsonism: Longitudinal MRI Study

Hwang

Yang²,

Kim³

et al. 2016

Neurodegener Dis

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Aims: To elucidate different patterns of progression of midbrain atrophy in patients with Richardson's syndrome (RS), progressive supranuclear palsy-parkinsonism (PSP-P), and Parkinson's disease (PD) using magnetic resonance imaging (MRI)-based visual rating indexes. Methods: We recruited 12 patients with PSP-RS, 12 with PSP-P, and 23 with PD for whom MRIs had been followed up for at least 2 years (mean ± SD, 4.9 ± 1.6 years) after the initial MRI. MRI-based visual rating indexes were used to estimate midbrain atrophy, including the ratio of the pontine to midbrain tegmental areas (P/M ratio) on a midsagittal image, the length between the interpeduncular fossa and the center of the cerebral aqueduct at the midmammillary-body level (M^TEGM) on axial images, and the morning glory sign. Results: Initially, there were no differences in MRI-based visual rating indexes between PSP-P and PD, while PSP-RS showed a higher P/M ratio and lower M^TEGM compared with PSP-P and PD. In PD, the P/M ratio and M^TEGM remained stable with disease progression. However, the extent of changes between initial and follow-up indexes was similarly greater for both PSP-RS and PSP-P than for PD. Finally, PSP-P showed a higher P/M ratio and lower M^TEGM compared with PD in the follow-up, while PSP-RS still exhibited the most profound changes. Conclusions: Midbrain atrophy progresses differentially in patients with PSP-RS, PSP-P, and PD. Longitudinal measurements of midbrain atrophy using MRI-based visual rating indexes can help distinguish patients with PSP-P from those with PSP-RS and PD.

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MRI measurements of brainstem structures in patients with Richardson's syndrome, progressive supranuclear palsy-parkinsonism, and Parkinson's disease

Cited by 118 publications

References 37 publications

Progression of brain atrophy in PSP and CBS over 6 months and 1 year

Progression of brain atrophy in PSP and CBS over 6 months and 1 year

Frontal Corpus Callosum Alterations in Progressive Supranuclear Palsy but Not in Parkinson's Disease

Differential Progression of Midbrain Atrophy in Parkinsonism: Longitudinal MRI Study

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