Objective: Using neuromelanin-sensitive magnetic resonance imaging (NM-MRI) and midbrain volumetry, we analyzed differences and relationships between nigral degeneration and midbrain atrophy in PSP and PD patients and evaluated diagnostic performance.

Background: Midbrain atrophy is considered a characteristic feature of progressive supranuclear palsy (PSP). However, the relationship between nigral degeneration and midbrain atrophy remains unclear. Nigral degeneration patterns are thought to differ between PSP and Parkinson’s disease (PD).

Methods: NM-MRI and midbrain volumetry were performed in 11 patients with PSP, 24 patients with PD, and 10 control subjects to measure the neuromelanin-sensitive substantia nigra pars compacta (NM-SNc) area and midbrain volume. NM-SNc area was divided into lateral and medial areas for subdivision analysis. Diagnostic accuracy for differentiating among disease groups and controls was measured using receiver operating characteristic analysis.

Results: The NM-SNc area and midbrain volume were significantly smaller in PSP compared with PD and controls. Motor deficits were inversely correlated with NM-SNc area in PD but not in PSP. There was no significant correlation between NM-SNc area and midbrain volume in either disease group. Subdivision analysis was in accord with pathological findings for both PSP and PD. Midbrain volumetry discriminated PSP from PD with high sensitivity and specificity, and diagnostic accuracy was improved when NM-MRI analysis was added.

Conclusions: NM-MRI and midbrain volumetry may reflect the specific clinical and pathological characteristics of patients with PSP as well as PD. Combined midbrain volumetry with NM-MRI analysis may be useful for differentiating PSP from PD.

References: Sasaki M, Shibata E, Tohyama K, et al. Neuromelanin magnetic resonance imaging of locus ceruleus and substantia nigra in Parkinson’s disease. Neuroreport 2006;17(11):1215-1218. Neuromelanin MRI is useful for monitoring motor complications in Parkinson’s and PARK2 disease. J Neural Transm (Vienna) 2017;124(4):407-415.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/neuromelanin-imaging-and-midbrain-volumetry-in-progressive-supranuclear-palsy-and-parkinsons-disease/