Accuracy of MR markers for differentiating Progressive Supranuclear Palsy from Parkinson's disease

• Published in: NeuroImage clinical 2016-01, Vol.11 (C), p.736-742
• Main Authors: Zanigni, Stefano, Calandra-Buonaura, Giovanna, Manners, David Neil, Testa, Claudia, Gibertoni, Dino, Evangelisti, Stefania, Sambati, Luisa, Guarino, Maria, De Massis, Patrizia, Gramegna, Laura Ludovica, Bianchini, Claudio, Rucci, Paola, Cortelli, Pietro, Lodi, Raffaele, Tonon, Caterina
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Brain - diagnostic imaging; Brain Mapping; DTI; Female; Humans; Image Processing, Computer-Assisted; Longitudinal Studies; Magnetic Resonance Imaging; Male; Middle Aged; Morphometry; MRI; Parkinson Disease - diagnostic imaging; Parkinson's disease; Progressive Supranuclear Palsy; Regular; Retrospective Studies; ROC Curve; Supranuclear Palsy, Progressive - diagnostic imaging
• ISSN: 2213-1582; 2213-1582
• DOI: 10.1016/j.nicl.2016.05.016

Advanced brain MR techniques are useful tools for differentiating Progressive Supranuclear Palsy from Parkinson's disease, although time-consuming and unlikely to be used all together in routine clinical work. We aimed to compare the diagnostic accuracy of quantitative morphometric, volumetric and DTI metrics for differentiating Progressive Supranuclear Palsy-Richardson's Syndrome from Parkinson's disease. 23 Progressive Supranuclear Palsy-Richardson's Syndrome and 42 Parkinson's disease patients underwent a standardized 1.5T brain MR protocol comprising high-resolution T1W1 and DTI sequences. Brainstem and cerebellar peduncles morphometry, automated volumetric analysis of brain deep gray matter and DTI metric analyses of specific brain structures were carried out. We determined diagnostic accuracy, sensitivity and specificity of MR-markers with respect to the clinical diagnosis by using univariate receiver operating characteristics curve analyses. Age-adjusted multivariate receiver operating characteristics analyses were then conducted including only MR-markers with a sensitivity and specificity exceeding 80%. Morphometric markers (midbrain area, pons to midbrain area ratio and MR Parkinsonism Index), DTI parameters (infratentorial structures) and volumetric analysis (thalamus, putamen and pallidus nuclei) presented moderate to high diagnostic accuracy in discriminating Progressive Supranuclear Palsy-Richardson's Syndrome from Parkinson's disease, with midbrain area showing the highest diagnostic accuracy (99%) (mean ± standard deviation: 75.87 ± 16.95 mm(2) vs 132.45 ± 20.94 mm(2), respectively; p