Highlights
- •Distinguishing PSP-P from PD is challenging in the early stages of the disease.
- •Few data exist on the usefulness of MRPI for diagnosing PSP-P patients.
- •MRPI 2.0 is a new version of MRPI which includes the 3rd ventricular width.
- •MRPI 2.0 accurately differentiated patients with PSP-P from those with PD.
- •MRPI 2.0 accurately diagnosed PSP-P in the absence of vertical ocular palsy.
Abstract
Introduction
Differentiating clinically progressive supranuclear palsy-parkinsonism (PSP-P) from Parkinson's disease (PD) may be challenging, especially in the absence of vertical supranuclear gaze palsy (VSGP). The Magnetic Resonance Parkinsonism Index (MRPI) has been reported to accurately distinguish between PSP and PD, yet few data exist on the usefulness of this biomarker for the differentiation of PSP-P from PD.
Methods
Thirty-four patients with PSP-P, 46 with PSP-Richardson's syndrome (PSP-RS), 53 with PD, and 53 controls were enrolled. New consensus criteria for the clinical diagnosis of PSP were used as the reference standard. The MRPI, and a new index termed MRPI 2.0 including the measurement of the third ventricle width (MRPI multiplied by third ventricle width/frontal horns width ratio), were calculated on T1-weighted MR images.
Results
The MRPI differentiated patients with PSP-P from those with PD with sensitivity and specificity of 73.5% and 98.1%, respectively, while the MRPI 2.0 showed higher sensitivity (100%) and similar specificity (94.3%) in differentiating between these two groups. Both biomarkers showed excellent performance in differentiating PSP-P patients with VSGP from those with PD, but the MRPI 2.0 was much more accurate (95.8%) than MRPI in differentiating PSP-P patients with slowness of vertical saccades from PD patients.
Conclusion
The MRPI 2.0 accurately differentiated PSP-P patients from those with PD. This new index was more powerful than MRPI in differentiating PSP patients in the early stage of the disease with slowness of vertical saccades from patients with PD, thus helping clinicians to consolidate the diagnosis based on clinical features, in vivo.
I was diagnosed in November 2007 with Parkinson's Disease. I have left side tremors, balance and gait issues and some non-motor symptoms: quiet voice, some cognitive decline, small handwriting. I am currently on Sinemet for tremors and Cymbalta for neuropathy related to diabetes and previous chemotherapy. It was on my 25th anniversary of surviving breast cancer that I got the PD diagnosis. I am 69, retired, single woman sharing a house with my sister. I like to read, quilt, and crochet. I have been reading up on PD. Until I read too much and it scares me. Then I put it away until I calm down and can research it some more. I need advice and some direction. I searched further, visited Parkinson’s websites, blogs. I find info about someone having the same symptoms. I was really determined. Fortunately for me, I stumbled on a testimony of someone who had Parkinson’s for several years and was cured through Herbal medication. I read awesome stories of people whose condition were worse. I was not a fan of Herbal Medication, because I once believed that they have not researched it enough. But due to numerous testimonies I was more than willing to try it…. I contacted Dr. Fabien, and I purchased the medicine and used just the way doctor instructed. Its a thing of joy to come back and make my review.. It became a miracle for me within 7 months. The herbal medication worked without any trace of side effects on I’m…. totally free. I have been cured for Parkinson’s. I was a shocking experience with the medicine. I never knew I will be free for Parkinson’s disease. Email dr.fabiencontantin@gmail.com or www.kunimeherbs.com
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