BACKGROUND: No prospective study of patients with Parkinson's disease (PD) has investigated the appearance of vertical gaze abnormalities, a feature suggestive of progressive supranuclear palsy (PSP). OBJECTIVE: To identify, within a cohort of patients with an initial diagnosis of PD, those who developed vertical gaze abnormalities during a 4-year follow-up, and to investigate the performance of new imaging biomarkers in predicting vertical gaze abnormalities. METHODS: A total of 110 patients initially classified as PD and 74 controls were enrolled. All patients underwent clinical assessment at baseline and every year up to the end of the follow-up. The pons/midbrain area ratio 2.0 and the Magnetic Resonance Parkinsonism Index 2.0 were calculated. RESULTS: After 4-year follow-up, 100 of 110 patients maintained the diagnosis of PD, whereas 10 PD patients (9.1%) developed vertical gaze abnormalities, suggesting an alternative diagnosis of PSP-parkinsonism. At baseline, the Magnetic Resonance Parkinsonism Index 2.0 was the most accurate biomarker in differentiating PD patients who developed vertical gaze abnormalities from those who maintained an initial diagnosis of PD. At the end of follow-up, both of these biomarkers accurately distinguished PSP-parkinsonism from PD. CONCLUSIONS: Our results demonstrate that a number of patients with an initial diagnosis of PD developed vertical gaze abnormalities during a 4-year follow-up, and the diagnosis was changed from PD to PSP-parkinsonism. In PD patients, baseline Magnetic Resonance Parkinsonism Index 2.0 showed the best performance in predicting the clinical evolution toward a PSP-parkinsonism phenotype, enabling PSP-parkinsonism patients to be identified at the earliest stage of the disease for promising disease-modifying therapies.
BACKGROUND: No prospective study of patients with Parkinson's disease (PD) has investigated the appearance of vertical gaze abnormalities, a feature suggestive of progressive supranuclear palsy (PSP). OBJECTIVE: To identify, within a cohort of patients with an initial diagnosis of PD, those who developed vertical gaze abnormalities during a 4-year follow-up, and to investigate the performance of new imaging biomarkers in predicting vertical gaze abnormalities. METHODS: A total of 110 patients initially classified as PD and 74 controls were enrolled. All patients underwent clinical assessment at baseline and every year up to the end of the follow-up. The pons/midbrain area ratio 2.0 and the Magnetic Resonance Parkinsonism Index 2.0 were calculated. RESULTS: After 4-year follow-up, 100 of 110 patients maintained the diagnosis of PD, whereas 10 PDpatients (9.1%) developed vertical gaze abnormalities, suggesting an alternative diagnosis of PSP-parkinsonism. At baseline, the Magnetic Resonance Parkinsonism Index 2.0 was the most accurate biomarker in differentiating PDpatients who developed vertical gaze abnormalities from those who maintained an initial diagnosis of PD. At the end of follow-up, both of these biomarkers accurately distinguished PSP-parkinsonism from PD. CONCLUSIONS: Our results demonstrate that a number of patients with an initial diagnosis of PD developed vertical gaze abnormalities during a 4-year follow-up, and the diagnosis was changed from PD to PSP-parkinsonism. In PDpatients, baseline Magnetic Resonance Parkinsonism Index 2.0 showed the best performance in predicting the clinical evolution toward a PSP-parkinsonism phenotype, enabling PSP-parkinsonismpatients to be identified at the earliest stage of the disease for promising disease-modifying therapies.
Keywords:
magnetic Resonance Parkinsonism Index 2.0; magnetic resonance parkinsonism index; pons/midbrain area ratio 2.0; progressive supranuclear palsy-parkinsonism; vertical gaze abnormalities
Authors: Marina Picillo; Filomena Abate; Sara Ponticorvo; Maria Francesca Tepedino; Roberto Erro; Daniela Frosini; Eleonora Del Prete; Paolo Cecchi; Mirco Cosottini; Roberto Ceravolo; Gianfranco Di Salle; Francesco Di Salle; Fabrizio Esposito; Maria Teresa Pellecchia; Renzo Manara; Paolo Barone Journal: Front Neurol Date: 2020-11-12 Impact factor: 4.003
Authors: Andrea Quattrone; Maria G Bianco; Angelo Antonini; David E Vaillancourt; Klaus Seppi; Roberto Ceravolo; Antonio P Strafella; Gioacchino Tedeschi; Alessandro Tessitore; Roberto Cilia; Maurizio Morelli; Salvatore Nigro; Basilio Vescio; Pier Paolo Arcuri; Rosa De Micco; Mario Cirillo; Luca Weis; Eleonora Fiorenzato; Roberta Biundo; Roxana G Burciu; Florian Krismer; Nikolaus R McFarland; Christoph Mueller; Elke R Gizewski; Mirco Cosottini; Eleonora Del Prete; Sonia Mazzucchi; Aldo Quattrone Journal: Mov Disord Date: 2022-04-11 Impact factor: 9.698
Authors: Andrea Quattrone; Maurizio Morelli; Maria G Bianco; Jolanda Buonocore; Alessia Sarica; Maria Eugenia Caligiuri; Federica Aracri; Camilla Calomino; Marida De Maria; Maria Grazia Vaccaro; Vera Gramigna; Antonio Augimeri; Basilio Vescio; Aldo Quattrone Journal: Brain Sci Date: 2022-07-20