Objective: We examined whetherquantitative MRI analysis of brain structure was useful for early diagnosis of PSP.

Background: Quantitative analysis of brain structure by means of MRI in patients with progressive supranuclear palsy (PSP) has showed that distribution of atrophy was useful for distinguishing PSP from Parkinson’s disease (PD). However, there has not been reported on the quantitative brain MRI analysis in an early stage of PSP patients.

Method: Six patients with clinically diagnosed PSP including predominant cerebellarataxia (C)andprogressive gait freezing (PGF), 3 cases of predominant parkinsonism (P). All cases were difficult to discriminate from PD in the early clinical stage. One case of Richardson’s syndrome (RS)and 4case of PDthat were able to be observed for a long time, were used as control.Brain segmentation and volumetric measurement by Free Surfer were performed on brain MRI images which were taken repeatedly with the clinical course.Z-score of each region was calculated in each case using analysis data of 536 healthy groups, and it was used to evaluate the brain structural changes.

Results: PSP group showed atrophy of the globus pallidus, thalamus and midbrain and enlargement of the third ventricle at the time of the first visit (within 0.8 to 2 years since onset) and those changes were proceeded with the clinical course.In PD group, structural change was not observed during the clinical course regarding the difference from the PSP group.

Conclusion: Quantitative MRI analysis of the brain structure detected a brain structure change in PSP group was different from that of PD group in the early onset before clinical diagnosis of PSP was confirmed (5 to 9 years after onset), suggesting that quantitative MRI analysis of brain structure is useful as an imaging biomarker for early diagnosis of PSP.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/early-diagnosis-of-progressive-supranuclear-palsy-using-quantitative-mri-analysis-of-brain-structure/