Highly specific radiographic marker predates clinical diagnosis in progressive supranuclear palsy

Emily Owens, Karl Krecke, J. E. Ahlskog, Robert Fealey, Anhar Hassan, Keith Anthony Josephs, Bryan Klassen, Joseph Matsumoto, James Howard Bower

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Introduction: The diagnosis of progressive supranuclear palsy is often challenging early in the course of the disease, when clinical signs of the condition may be less apparent and patients do not clearly meet diagnostic criteria. In this study, we examine a potential radiographic marker in progressive supranuclear palsy, and assess the timing of its presence in relation to diagnosis. Methods: A retrospective review of patients fulfilling clinical research criteria for multiple system atrophy, Parkinson's disease, and progressive supranuclear palsy (total n = 75) was performed. Midbrain and pontine diameters, and the midbrain to pons ratio were calculated by a neuroradiologist blinded to the clinical diagnosis. The timing of the presence of a midbrain to pons ratio of less than or equal to 0.52 was assessed in the progressive supranuclear palsy group in reference to the time of diagnosis. Results: The midbrain to pons ratio was significantly reduced in the progressive supranuclear palsy cohort (p <0.0001), and a midbrain to pons ratio of less than or equal to 0.52 was 100% specific for progressive supranuclear palsy. This radiologic sign predated the clinical diagnosis of progressive supranuclear palsy by a mean of 15 months (range 1-47 months) in 14 of 17 (82%) of patients in whom it was found. Conclusions: The midbrain to pons ratio is an easily applied and highly specific tool in the diagnosis of progressive supranuclear palsy, and is frequently present before the diagnosis is made.

Original languageEnglish (US)
JournalParkinsonism and Related Disorders
DOIs
StateAccepted/In press - Feb 1 2016

Fingerprint

Progressive Supranuclear Palsy
Prednisolone
Mesencephalon
Biomarkers
Pons
Multiple System Atrophy
Parkinson Disease

Keywords

  • Imaging
  • MRI
  • Progressive supranuclear palsy

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Clinical Neurology
  • Neurology

Cite this

Highly specific radiographic marker predates clinical diagnosis in progressive supranuclear palsy. / Owens, Emily; Krecke, Karl; Ahlskog, J. E.; Fealey, Robert; Hassan, Anhar; Josephs, Keith Anthony; Klassen, Bryan; Matsumoto, Joseph; Bower, James Howard.

In: Parkinsonism and Related Disorders, 01.02.2016.

Research output: Contribution to journalArticle

@article{2f91caee7ac6446788b4ec3f49f1f26e,
title = "Highly specific radiographic marker predates clinical diagnosis in progressive supranuclear palsy",
abstract = "Introduction: The diagnosis of progressive supranuclear palsy is often challenging early in the course of the disease, when clinical signs of the condition may be less apparent and patients do not clearly meet diagnostic criteria. In this study, we examine a potential radiographic marker in progressive supranuclear palsy, and assess the timing of its presence in relation to diagnosis. Methods: A retrospective review of patients fulfilling clinical research criteria for multiple system atrophy, Parkinson's disease, and progressive supranuclear palsy (total n = 75) was performed. Midbrain and pontine diameters, and the midbrain to pons ratio were calculated by a neuroradiologist blinded to the clinical diagnosis. The timing of the presence of a midbrain to pons ratio of less than or equal to 0.52 was assessed in the progressive supranuclear palsy group in reference to the time of diagnosis. Results: The midbrain to pons ratio was significantly reduced in the progressive supranuclear palsy cohort (p <0.0001), and a midbrain to pons ratio of less than or equal to 0.52 was 100{\%} specific for progressive supranuclear palsy. This radiologic sign predated the clinical diagnosis of progressive supranuclear palsy by a mean of 15 months (range 1-47 months) in 14 of 17 (82{\%}) of patients in whom it was found. Conclusions: The midbrain to pons ratio is an easily applied and highly specific tool in the diagnosis of progressive supranuclear palsy, and is frequently present before the diagnosis is made.",
keywords = "Imaging, MRI, Progressive supranuclear palsy",
author = "Emily Owens and Karl Krecke and Ahlskog, {J. E.} and Robert Fealey and Anhar Hassan and Josephs, {Keith Anthony} and Bryan Klassen and Joseph Matsumoto and Bower, {James Howard}",
year = "2016",
month = "2",
day = "1",
doi = "10.1016/j.parkreldis.2016.05.006",
language = "English (US)",
journal = "Parkinsonism and Related Disorders",
issn = "1353-8020",
publisher = "Elsevier BV",

}

TY - JOUR

T1 - Highly specific radiographic marker predates clinical diagnosis in progressive supranuclear palsy

AU - Owens, Emily

AU - Krecke, Karl

AU - Ahlskog, J. E.

AU - Fealey, Robert

AU - Hassan, Anhar

AU - Josephs, Keith Anthony

AU - Klassen, Bryan

AU - Matsumoto, Joseph

AU - Bower, James Howard

PY - 2016/2/1

Y1 - 2016/2/1

N2 - Introduction: The diagnosis of progressive supranuclear palsy is often challenging early in the course of the disease, when clinical signs of the condition may be less apparent and patients do not clearly meet diagnostic criteria. In this study, we examine a potential radiographic marker in progressive supranuclear palsy, and assess the timing of its presence in relation to diagnosis. Methods: A retrospective review of patients fulfilling clinical research criteria for multiple system atrophy, Parkinson's disease, and progressive supranuclear palsy (total n = 75) was performed. Midbrain and pontine diameters, and the midbrain to pons ratio were calculated by a neuroradiologist blinded to the clinical diagnosis. The timing of the presence of a midbrain to pons ratio of less than or equal to 0.52 was assessed in the progressive supranuclear palsy group in reference to the time of diagnosis. Results: The midbrain to pons ratio was significantly reduced in the progressive supranuclear palsy cohort (p <0.0001), and a midbrain to pons ratio of less than or equal to 0.52 was 100% specific for progressive supranuclear palsy. This radiologic sign predated the clinical diagnosis of progressive supranuclear palsy by a mean of 15 months (range 1-47 months) in 14 of 17 (82%) of patients in whom it was found. Conclusions: The midbrain to pons ratio is an easily applied and highly specific tool in the diagnosis of progressive supranuclear palsy, and is frequently present before the diagnosis is made.

AB - Introduction: The diagnosis of progressive supranuclear palsy is often challenging early in the course of the disease, when clinical signs of the condition may be less apparent and patients do not clearly meet diagnostic criteria. In this study, we examine a potential radiographic marker in progressive supranuclear palsy, and assess the timing of its presence in relation to diagnosis. Methods: A retrospective review of patients fulfilling clinical research criteria for multiple system atrophy, Parkinson's disease, and progressive supranuclear palsy (total n = 75) was performed. Midbrain and pontine diameters, and the midbrain to pons ratio were calculated by a neuroradiologist blinded to the clinical diagnosis. The timing of the presence of a midbrain to pons ratio of less than or equal to 0.52 was assessed in the progressive supranuclear palsy group in reference to the time of diagnosis. Results: The midbrain to pons ratio was significantly reduced in the progressive supranuclear palsy cohort (p <0.0001), and a midbrain to pons ratio of less than or equal to 0.52 was 100% specific for progressive supranuclear palsy. This radiologic sign predated the clinical diagnosis of progressive supranuclear palsy by a mean of 15 months (range 1-47 months) in 14 of 17 (82%) of patients in whom it was found. Conclusions: The midbrain to pons ratio is an easily applied and highly specific tool in the diagnosis of progressive supranuclear palsy, and is frequently present before the diagnosis is made.

KW - Imaging

KW - MRI

KW - Progressive supranuclear palsy

UR - http://www.scopus.com/inward/record.url?scp=84965028335&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84965028335&partnerID=8YFLogxK

U2 - 10.1016/j.parkreldis.2016.05.006

DO - 10.1016/j.parkreldis.2016.05.006

M3 - Article

C2 - 27160570

AN - SCOPUS:84965028335

JO - Parkinsonism and Related Disorders

JF - Parkinsonism and Related Disorders

SN - 1353-8020

ER -