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Neurology. 2016 Sep 20;87(12):1266-73. doi: 10.1212/WNL.0000000000003125. Epub 2016 Aug 24.

MR parkinsonism index predicts vertical supranuclear gaze palsy in patients with PSP-parkinsonism.

Author information

1
From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy. aldo.quattrone@gmail.com.
2
From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy.

Abstract

OBJECTIVE:

To identify a biomarker for predicting the appearance of vertical supranuclear gaze palsy (VSGP) in patients affected by progressive supranuclear palsy-parkinsonism (PSP-P).

METHODS:

Twenty-four patients with PSP-P were enrolled in the current study. Patients were clinically followed up every 6 months until the appearance of VSGP or the end of the follow-up (4 years). Participants underwent MRI at baseline and at the end of follow-up. Magnetic resonance parkinsonism index (MRPI), an imaging measure useful for diagnosing PSP, was calculated.

RESULTS:

Twenty-one patients with PSP-P completed follow-up, and 3 patients dropped out. Eleven of 21 patients with PSP-P developed VSGP after a mean follow-up period of 28.5 months (range 6-48 months), while the remaining 10 patients with PSP-P did not develop VSGP during the 4-year follow-up period. At baseline, patients with PSP-P who later developed VSGP had MRPI values significantly higher than those of patients not developing VSGP without overlapping values between the 2 groups. MRPI showed a higher accuracy (100%) in predicting VSGP than vertical ocular slowness (accuracy 33.3%) or postural instability with or without vertical ocular slowness (accuracy 71.4% and 42.9%, respectively).

CONCLUSIONS:

Our study demonstrates that MRPI accurately predicted, on an individual basis, the appearance of VSGP in patients with PSP-P, thus confirming clinical diagnosis in vivo.

PMID:
27558375
PMCID:
PMC5035983
DOI:
10.1212/WNL.0000000000003125
[Indexed for MEDLINE]
Free PMC Article

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