Characterization and diagnostic potential of R2 in early-stage progressive supranuclear palsy variants

• Published in: Parkinsonism & related disorders 2022-08, Vol.101, p.43-48
• Main Authors: Beliveau, Vincent, Müller, Christoph, Steiger, Ruth, Gizewski, Elke R., Poewe, Werner, Seppi, Klaus, Scherfler, Christoph
• Format: Article
• Language: English
• Subjects: Brain iron; Convolutional neural network; Diagnostic marker; Progressive supranuclear palsy
• ISSN: 1353-8020; 1873-5126
• DOI: 10.1016/j.parkreldis.2022.06.021

Iron accumulation in subcortical brain nuclei has been shown to be differentially increased in atypical parkinsonian disorders. It is unclear whether the patterns of iron accumulation are consistent between variants of progressive supranuclear palsy (PSP) and their diagnostic utility in early to moderately advanced stages of the diseases. Brain iron content (R2*) was quantified using magnetic resonance imaging in patients clinically diagnosed as PSP – parkinsonism (PSP–P, n = 15), PSP – Richardson's syndrome (PSP-RS, n = 14), Parkinson's disease (PD, n = 15), or the parkinsonian variant of multiple system atrophy (MSA-P, n = 14) using established criteria, and healthy controls (HC). Disease duration was less than 5 years in all patients. The quantification of regional R2* was performed using a semi-automatized approach. Significant group differences in R2*, primarily within the red nucleus and the substantia nigra, were identified between PSP, PD, MSA-P, and HC, but not between PSP-P and PSP-RS. However, distinct R2* correlation patterns across brain regions were observed for the different groups. Good classification performances (sensitivity and specificity >80%) were only obtained for PSP vs. HC. For all other comparisons, sensitivity and/or specificity was below