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Diagnostic Accuracy of Magnetic Resonance Imaging Measures of Brain Atrophy Across the Spectrum of Progressive Supranuclear Palsy and Corticobasal Degeneration
IMPORTANCE: The accurate diagnosis of progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) is hampered by imperfect clinical-pathological correlations. OBJECTIVE: To assess and compare the diagnostic value of the magnetic resonance parkinsonism index (MRPI) and other magnetic res...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Medical Association
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9055455/ https://www.ncbi.nlm.nih.gov/pubmed/35486397 http://dx.doi.org/10.1001/jamanetworkopen.2022.9588 |
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author | Illán-Gala, Ignacio Nigro, Salvatore VandeVrede, Lawren Falgàs, Neus Heuer, Hilary W. Painous, Cèlia Compta, Yaroslau Martí, Maria J. Montal, Victor Pagonabarraga, Javier Kulisevsky, Jaime Lleó, Alberto Fortea, Juan Logroscino, Giancarlo Quattrone, Andrea Quattrone, Aldo Perry, David C. Gorno-Tempini, Maria Luisa Rosen, Howard J. Grinberg, Lea T. Spina, Salvatore La Joie, Renaud Rabinovici, Gil D. Miller, Bruce L. Rojas, Julio C. Seeley, William W. Boxer, Adam L. |
author_facet | Illán-Gala, Ignacio Nigro, Salvatore VandeVrede, Lawren Falgàs, Neus Heuer, Hilary W. Painous, Cèlia Compta, Yaroslau Martí, Maria J. Montal, Victor Pagonabarraga, Javier Kulisevsky, Jaime Lleó, Alberto Fortea, Juan Logroscino, Giancarlo Quattrone, Andrea Quattrone, Aldo Perry, David C. Gorno-Tempini, Maria Luisa Rosen, Howard J. Grinberg, Lea T. Spina, Salvatore La Joie, Renaud Rabinovici, Gil D. Miller, Bruce L. Rojas, Julio C. Seeley, William W. Boxer, Adam L. |
author_sort | Illán-Gala, Ignacio |
collection | PubMed |
description | IMPORTANCE: The accurate diagnosis of progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) is hampered by imperfect clinical-pathological correlations. OBJECTIVE: To assess and compare the diagnostic value of the magnetic resonance parkinsonism index (MRPI) and other magnetic resonance imaging–based measures of cerebral atrophy to differentiate between PSP, CBD, and other neurodegenerative diseases. DESIGN, SETTING, AND PARTICIPANTS: This prospective diagnostic study included participants with 4-repeat tauopathies (4RT), PSP, CBD, other neurodegenerative diseases and available MRI who appeared in the University of California, San Francisco, Memory and Aging Center database. Data were collected from October 27, 1994, to September 29, 2019. Data were analyzed from March 1 to September 14, 2021. MAIN OUTCOMES AND MEASURES: The main outcome of this study was the neuropathological diagnosis of PSP or CBD. The clinical diagnosis at the time of the MRI acquisition was noted. The imaging measures included the MRPI, cortical thickness, subcortical volumes, including the midbrain, pons, and superior cerebellar peduncle volumes. Multinomial logistic regression models (MLRM) combining different cortical and subcortical regions were defined to discriminate between PSP, CBD, and other pathologies. The areas under the receiver operating characteristic curves (AUROC) and cutoffs were calculated to differentiate between PSP, CBD, and other diseases. RESULTS: Of the 326 included participants, 176 (54%) were male, and the mean (SD) age at MRI was 64.1 (8.0) years. The MRPI showed good diagnostic accuracy for the differentiation between PSP and all other pathologies (accuracy, 87%; AUROC, 0.90; 95% CI, 0.86-0.95) and between 4RT and other pathologies (accuracy, 80%; AUROC, 0.82; 95% CI, 0.76-0.87), but did not allow the discrimination of participants with CBD. Its diagnostic accuracy was lower in the subgroup of patients without the canonical PSP–Richardson syndrome (PSP-RS) or probable corticobasal syndrome (CBS) at MRI. MLRM combining cortical and subcortical measurements showed the highest accuracy for the differentiation between PSP and other pathologies (accuracy, 95%; AUROC, 0.98; 95% CI, 0.97-0.99), CBD and other pathologies (accuracy, 83%; AUROC, 0.86; 95% CI, 0.81-0.91), 4RT and other pathologies (accuracy, 89%; AUROC, 0.94; 95% CI, 0.92-0.97), and PSP and CBD (accuracy, 91%; AUROC, 0.95; 95% CI, 0.91-0.99), even in participants without PSP-RS or CBS at MRI. CONCLUSIONS AND RELEVANCE: In this study, the combination of widely available cortical and subcortical measures of atrophy on MRI discriminated between PSP, CBD, and other pathologies and could be used to support the diagnosis of 4RT in clinical practice. |
format | Online Article Text |
id | pubmed-9055455 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | American Medical Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-90554552022-05-02 Diagnostic Accuracy of Magnetic Resonance Imaging Measures of Brain Atrophy Across the Spectrum of Progressive Supranuclear Palsy and Corticobasal Degeneration Illán-Gala, Ignacio Nigro, Salvatore VandeVrede, Lawren Falgàs, Neus Heuer, Hilary W. Painous, Cèlia Compta, Yaroslau Martí, Maria J. Montal, Victor Pagonabarraga, Javier Kulisevsky, Jaime Lleó, Alberto Fortea, Juan Logroscino, Giancarlo Quattrone, Andrea Quattrone, Aldo Perry, David C. Gorno-Tempini, Maria Luisa Rosen, Howard J. Grinberg, Lea T. Spina, Salvatore La Joie, Renaud Rabinovici, Gil D. Miller, Bruce L. Rojas, Julio C. Seeley, William W. Boxer, Adam L. JAMA Netw Open Original Investigation IMPORTANCE: The accurate diagnosis of progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) is hampered by imperfect clinical-pathological correlations. OBJECTIVE: To assess and compare the diagnostic value of the magnetic resonance parkinsonism index (MRPI) and other magnetic resonance imaging–based measures of cerebral atrophy to differentiate between PSP, CBD, and other neurodegenerative diseases. DESIGN, SETTING, AND PARTICIPANTS: This prospective diagnostic study included participants with 4-repeat tauopathies (4RT), PSP, CBD, other neurodegenerative diseases and available MRI who appeared in the University of California, San Francisco, Memory and Aging Center database. Data were collected from October 27, 1994, to September 29, 2019. Data were analyzed from March 1 to September 14, 2021. MAIN OUTCOMES AND MEASURES: The main outcome of this study was the neuropathological diagnosis of PSP or CBD. The clinical diagnosis at the time of the MRI acquisition was noted. The imaging measures included the MRPI, cortical thickness, subcortical volumes, including the midbrain, pons, and superior cerebellar peduncle volumes. Multinomial logistic regression models (MLRM) combining different cortical and subcortical regions were defined to discriminate between PSP, CBD, and other pathologies. The areas under the receiver operating characteristic curves (AUROC) and cutoffs were calculated to differentiate between PSP, CBD, and other diseases. RESULTS: Of the 326 included participants, 176 (54%) were male, and the mean (SD) age at MRI was 64.1 (8.0) years. The MRPI showed good diagnostic accuracy for the differentiation between PSP and all other pathologies (accuracy, 87%; AUROC, 0.90; 95% CI, 0.86-0.95) and between 4RT and other pathologies (accuracy, 80%; AUROC, 0.82; 95% CI, 0.76-0.87), but did not allow the discrimination of participants with CBD. Its diagnostic accuracy was lower in the subgroup of patients without the canonical PSP–Richardson syndrome (PSP-RS) or probable corticobasal syndrome (CBS) at MRI. MLRM combining cortical and subcortical measurements showed the highest accuracy for the differentiation between PSP and other pathologies (accuracy, 95%; AUROC, 0.98; 95% CI, 0.97-0.99), CBD and other pathologies (accuracy, 83%; AUROC, 0.86; 95% CI, 0.81-0.91), 4RT and other pathologies (accuracy, 89%; AUROC, 0.94; 95% CI, 0.92-0.97), and PSP and CBD (accuracy, 91%; AUROC, 0.95; 95% CI, 0.91-0.99), even in participants without PSP-RS or CBS at MRI. CONCLUSIONS AND RELEVANCE: In this study, the combination of widely available cortical and subcortical measures of atrophy on MRI discriminated between PSP, CBD, and other pathologies and could be used to support the diagnosis of 4RT in clinical practice. American Medical Association 2022-04-29 /pmc/articles/PMC9055455/ /pubmed/35486397 http://dx.doi.org/10.1001/jamanetworkopen.2022.9588 Text en Copyright 2022 Illán-Gala I et al. JAMA Network Open. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the CC-BY License. |
spellingShingle | Original Investigation Illán-Gala, Ignacio Nigro, Salvatore VandeVrede, Lawren Falgàs, Neus Heuer, Hilary W. Painous, Cèlia Compta, Yaroslau Martí, Maria J. Montal, Victor Pagonabarraga, Javier Kulisevsky, Jaime Lleó, Alberto Fortea, Juan Logroscino, Giancarlo Quattrone, Andrea Quattrone, Aldo Perry, David C. Gorno-Tempini, Maria Luisa Rosen, Howard J. Grinberg, Lea T. Spina, Salvatore La Joie, Renaud Rabinovici, Gil D. Miller, Bruce L. Rojas, Julio C. Seeley, William W. Boxer, Adam L. Diagnostic Accuracy of Magnetic Resonance Imaging Measures of Brain Atrophy Across the Spectrum of Progressive Supranuclear Palsy and Corticobasal Degeneration |
title | Diagnostic Accuracy of Magnetic Resonance Imaging Measures of Brain Atrophy Across the Spectrum of Progressive Supranuclear Palsy and Corticobasal Degeneration |
title_full | Diagnostic Accuracy of Magnetic Resonance Imaging Measures of Brain Atrophy Across the Spectrum of Progressive Supranuclear Palsy and Corticobasal Degeneration |
title_fullStr | Diagnostic Accuracy of Magnetic Resonance Imaging Measures of Brain Atrophy Across the Spectrum of Progressive Supranuclear Palsy and Corticobasal Degeneration |
title_full_unstemmed | Diagnostic Accuracy of Magnetic Resonance Imaging Measures of Brain Atrophy Across the Spectrum of Progressive Supranuclear Palsy and Corticobasal Degeneration |
title_short | Diagnostic Accuracy of Magnetic Resonance Imaging Measures of Brain Atrophy Across the Spectrum of Progressive Supranuclear Palsy and Corticobasal Degeneration |
title_sort | diagnostic accuracy of magnetic resonance imaging measures of brain atrophy across the spectrum of progressive supranuclear palsy and corticobasal degeneration |
topic | Original Investigation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9055455/ https://www.ncbi.nlm.nih.gov/pubmed/35486397 http://dx.doi.org/10.1001/jamanetworkopen.2022.9588 |
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