Characterization and diagnostic potential of R2* in early-stage progressive supranuclear palsy variants. (August 2022)

• Record Type: Journal Article
• Authors: Beliveau, Vincent; Müller, Christoph; Steiger, Ruth; Gizewski, Elke R.; Poewe, Werner; Seppi, Klaus; Scherfler, Christoph
• Is Part Of: Parkinsonism & related disorders. Volume 101(2022)
• Page Start: 43
• Page End: 48
• Publication Date: 2022-08
• Subjects: Progressive supranuclear palsy -- Brain iron -- R2* -- Convolutional neural network -- Diagnostic marker; Parkinson's disease -- Periodicals; Movement disorders -- Periodicals; Movement Disorders -- Periodicals; Nerve Degeneration -- Periodicals; Nervous System Diseases -- Periodicals; Parkinson Disease -- Periodicals; Tremor -- Periodicals; Parkinson, Maladie de -- Périodiques; Parkinson's disease; 616.833
• DOI: 10.1016/j.parkreldis.2022.06.021
• Languages: English
• ISSNs: 1353-8020

Abstract

Abstract: Introduction: Iron accumulation in subcortical brain nuclei has been shown to be differentially increased in atypical parkinsonian disorders. It is unclear whether the patterns of iron accumulation are consistent between variants of progressive supranuclear palsy (PSP) and their diagnostic utility in early to moderately advanced stages of the diseases. Methods: Brain iron content (R2 *) was quantified using magnetic resonance imaging in patients clinically diagnosed as PSP – parkinsonism (PSP–P, n = 15), PSP – Richardson's syndrome (PSP-RS, n = 14), Parkinson's disease (PD, n = 15), or the parkinsonian variant of multiple system atrophy (MSA-P, n = 14) using established criteria, and healthy controls (HC). Disease duration was less than 5 years in all patients. The quantification of regional R2 * was performed using a semi-automatized approach. Results: Significant group differences in R2 *, primarily within the red nucleus and the substantia nigra, were identified between PSP, PD, MSA-P, and HC, but not between PSP-P and PSP-RS. However, distinct R2 * correlation patterns across brain regions were observed for the different groups. Good classification performances (sensitivity and specificity >80%) were only obtained for PSP vs. HC. For all other comparisons, sensitivity and/or specificity was below <70%. Conclusion: Iron accumulation in subcortical brain nuclei has distinct correlated patterns in PSP-P and PSP-RS, which could be reflecting different pathophysiological mechanisms. Increased iron content in these nuclei appears to be a predictor for atypical parkinsonian disorders such as PSP and MSA. Further studies are required to reproduce this finding and elucidate the evolution of these patterns over the course of the disease. Highlights: Iron content (R2 *) of brain nuclei was not significantly different between PSP-P and PSP-RS. Different patterns of R2 *correlation across brain regions were identified for PSP-P and PSP-RS. Reasonable classification of atypical parkinsonism can be achieved with R2 * of brain nuclei.