TY - JOUR
T1 - Midbrain atrophy in patients with presymptomatic progressive supranuclear palsy-Richardson's syndrome
AU - Ahn, Jong Hyeon
AU - Kim, Minkyeong
AU - Kim, Ji Sun
AU - Youn, Jinyoung
AU - Jang, Wooyoung
AU - Oh, Eungseok
AU - Lee, Phil Hyu
AU - Koh, Seong Beom
AU - Ahn, Tae Beom
AU - Cho, Jin Whan
N1 - Publisher Copyright:
© 2019 Elsevier Ltd
PY - 2019/9
Y1 - 2019/9
N2 - Introduction: In the present study, midbrain atrophy and the pons-to-midbrain area ratio (P/M ratio) were investigated as diagnostic markers for presymptomatic progressive supranuclear palsy-Richardson's syndrome (Pre-PSP-RS). Methods: The present study included 27 patients with probable PSP-RS who underwent brain MRI at least twice before and after the development of clinical symptoms, age- and sex-matched participants with Parkinson's disease (PD, n = 27), and healthy controls (n = 27). The midbrain area, pons area, and P/M ratio of the Pre-PSP-RS, PD, and control subjects were measured using midsagittal images from brain MRI, and the parameters were compared among the groups. Results: The midbrain area decreased and the P/M ratio increased significantly in the Pre-PSP-RS patients compared with both the PD and control subjects (midbrain, Pre-PSP-RS vs. PD = 1.01 cm2 vs. 1.29 cm2, p < 0.001, Pre-PSP-RS vs. controls = 1.01 cm2 vs. 1.29 cm2, p < 0.001; P/M ratio, Pre-PSP-RS vs. PD = 5.27 vs. 4.03, p < 0.001, Pre-PSP-RS vs. controls = 5.27 cm2 vs. 4.06 cm2, p < 0.001). The P/M ratio had high sensitivity (vs. PD, 96.3%, vs. control, 88.9%) and specificity (vs. PD, 81.5%, vs. control, 96.3%) in differentiating Pre-PSP-RS patients from PD and control subjects. Conclusion: Midbrain atrophy precedes the clinical symptoms of PSP-RS and could be a useful diagnostic imaging biomarker for Pre-PSP-RS. Furthermore, this information could play an important role in the development of future treatment strategies.
AB - Introduction: In the present study, midbrain atrophy and the pons-to-midbrain area ratio (P/M ratio) were investigated as diagnostic markers for presymptomatic progressive supranuclear palsy-Richardson's syndrome (Pre-PSP-RS). Methods: The present study included 27 patients with probable PSP-RS who underwent brain MRI at least twice before and after the development of clinical symptoms, age- and sex-matched participants with Parkinson's disease (PD, n = 27), and healthy controls (n = 27). The midbrain area, pons area, and P/M ratio of the Pre-PSP-RS, PD, and control subjects were measured using midsagittal images from brain MRI, and the parameters were compared among the groups. Results: The midbrain area decreased and the P/M ratio increased significantly in the Pre-PSP-RS patients compared with both the PD and control subjects (midbrain, Pre-PSP-RS vs. PD = 1.01 cm2 vs. 1.29 cm2, p < 0.001, Pre-PSP-RS vs. controls = 1.01 cm2 vs. 1.29 cm2, p < 0.001; P/M ratio, Pre-PSP-RS vs. PD = 5.27 vs. 4.03, p < 0.001, Pre-PSP-RS vs. controls = 5.27 cm2 vs. 4.06 cm2, p < 0.001). The P/M ratio had high sensitivity (vs. PD, 96.3%, vs. control, 88.9%) and specificity (vs. PD, 81.5%, vs. control, 96.3%) in differentiating Pre-PSP-RS patients from PD and control subjects. Conclusion: Midbrain atrophy precedes the clinical symptoms of PSP-RS and could be a useful diagnostic imaging biomarker for Pre-PSP-RS. Furthermore, this information could play an important role in the development of future treatment strategies.
KW - Biomarker
KW - Midbrain atrophy
KW - Pons-to-midbrain ratio
KW - Presymptomatic PSP
KW - Progressive supranuclear palsy
KW - Richardson's syndrome
UR - http://www.scopus.com/inward/record.url?scp=85068734654&partnerID=8YFLogxK
U2 - 10.1016/j.parkreldis.2019.07.009
DO - 10.1016/j.parkreldis.2019.07.009
M3 - Article
C2 - 31307918
AN - SCOPUS:85068734654
SN - 1353-8020
VL - 66
SP - 80
EP - 86
JO - Parkinsonism and Related Disorders
JF - Parkinsonism and Related Disorders
ER -