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Sci Rep. 2019 Apr 15;9(1):6079. doi: 10.1038/s41598-019-42565-4.

Mapping of apparent susceptibility yields promising diagnostic separation of progressive supranuclear palsy from other causes of parkinsonism.

Author information

1
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, 171 65, Sweden. henrik.sjostrom@ki.se.
2
Department of Neurology, Karolinska University Hospital, Stockholm, 141 86, Sweden. henrik.sjostrom@ki.se.
3
Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, 212 24, Malmö, Sweden.
4
Neurology Clinic, Skåne University Hospital, Lund, 221 85, Sweden.
5
Clinical Sciences Lund, Department of Radiology, Lund University, Lund, 221 85, Sweden.
6
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, 171 65, Sweden.
7
Department of Radiology, Karolinska University Hospital, Stockholm, 141 86, Sweden.
8
Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, 141 57, Sweden.
9
Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, United Kingdom.
10
Diagnostic Radiology, Department of Clinical Sciences, Lund University, Lund, 221 85, Sweden.
11
Department for Image and Function, Skåne University Hospital, Lund, 221 85, Sweden.
12
Department of Neurology, Karolinska University Hospital, Stockholm, 141 86, Sweden.
13
Memory Clinic, Skåne University Hospital, Malmö, 212 24, Sweden.

Abstract

There is a need for methods that distinguish Parkinson's disease (PD) from progressive supranuclear palsy (PSP) and multiple system atrophy (MSA), which have similar characteristics in the early stages of the disease. In this prospective study, we evaluate mapping of apparent susceptibility based on susceptibility weighted imaging (SWI) for differential diagnosis. We included 134 patients with PD, 11 with PSP, 10 with MSA and 44 healthy controls. SWI data were processed into maps of apparent susceptibility. In PSP, apparent susceptibility was increased in the red nucleus compared to all other groups, and in globus pallidus, putamen, substantia nigra and the dentate nucleus compared to PD and controls. In MSA, putaminal susceptibility was increased compared to PD and controls. Including all studied regions and using discriminant analysis between PSP and PD, 100% sensitivity and 97% specificity was achieved, and 91% sensitivity and 90% specificity in separating PSP from MSA. Correlations between putaminal susceptibility and disease severity in PD could warrant further research into using susceptibility mapping for monitoring disease progression and in clinical trials. Our study indicates that susceptibility in deep nuclei could play a role in the diagnosis of atypical parkinsonism, especially in PSP.

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