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Mov Disord. 2017 May;32(5):778-782. doi: 10.1002/mds.26921. Epub 2017 Feb 2.

Manual MRI morphometry in Parkinsonian syndromes.

Author information

1
Department of Neurology, Philipps University Marburg, Marburg, Germany.
2
Department of Neurology, University of Ulm, Ulm, Germany.
3
Institute of Clinical Neuroscience and Medical Psychology, and Department of Neurology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
4
Klinikum Ernst von Bergmann, Potsdam, Germany.
5
Departement of Neurology, Johann Wolfgang Goethe University, Frankfurt, Germany.
6
Department of Neuroradiology, Johann Wolfgang Goethe University, Frankfurt, Germany.
7
Department of Neuroradiology, Medical University Center Freiburg, Freiburg, Germany.
8
Department of Neurology, Medical University Center Freiburg, Freiburg, Germany.
9
Department of Neurology, Technische Universität München, Munich, Germany.
10
German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
11
Parkinson's Disease and Movement Disorders Department, HYGEIA Hospital, Athens, Greece and Second Dept. of Neurology, Attikon Hospital, University of Athens Greece.
12
Department of Children and Youth Medicine, Philipps University Marburg, Marburg, Germany.
13
Swiss Epilepsy Center, Zurich, Switzerland.

Abstract

BACKGROUND:

Several morphometric magnetic resonance imaging parameters may serve for differential diagnosis of parkinsonism. The objective of this study was to identify which performs best in clinical routine.

METHODS:

We acquired multicentric magnetization-prepared rapid gradient echo sequences in patients with Parkinson's disease (n=204), progressive supranuclear palsy (n=106), multiple system atrophy-cerebellar, (n = 21); multiple system atrophy-parkinsonian (n = 60), and healthy controls (n = 73), performed manual planimetric measurements, and calculated receiver operator characteristics with leave-one-out cross-validation to propose cutoff values.

RESULTS:

The midsagittal midbrain area was reduced in PSP versus all other groups (P < 0.001). The midsagittal pons area was reduced in MSA-cerebellar, MSA-parkinsonian, and PSP versus PD patients and healthy controls (P < 0.001). The midbrain/pons area ratio was lower in PSP (P < 0.001) and higher in MSA-cerebellar and MSA-parkinsonian versus PD and PSP (P < 0.001).

CONCLUSIONS:

The midsagittal midbrain area most reliably identified PSP, the midsagittal pons area MSA-cerebellar. The midbrain/pons area ratio differentiated MSA-cerebellar and PSP better than the magnetic resonance-Parkinson index. © 2017 International Parkinson and Movement Disorder Society.

KEYWORDS:

Parkinson's disease; magnetic resonance imaging; morphometry; multiple system atrophy; progressive supranuclear palsy

PMID:
28150443
DOI:
10.1002/mds.26921
[Indexed for MEDLINE]

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