Andrea Quattrone1, Maria Eugenia Caligiuri2, Maurizio Morelli3, Salvatore Nigro4, Basilio Vescio5, Gennarina Arabia3, Giuseppe Nicoletti4, Rita Nisticò4, Maria Salsone4, Fabiana Novellino4, Gaetano Barbagallo1, Maria Grazia Vaccaro4, Umberto Sabatini6, Virginia Vescio6, Carlo Stanà6, Federico Rocca4, Manuela Caracciolo4, Aldo Quattrone7. 1. Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy. 2. Neuroscience Center, Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy. 3. Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy. 4. Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy. 5. Biotecnomed, S.C.aR.L, Catanzaro, Italy. 6. Institute of Neuroradiology, Magna Graecia University, Catanzaro, Italy. 7. Neuroscience Center, Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Catanzaro, Italy. Electronic address: quattrone@unicz.it.
Abstract
INTRODUCTION: We investigated the imaging counterpart of two functional domains (ocular motor dysfunction and postural instability) in progressive supranuclear palsy (PSP) patients classified according to the new clinical diagnostic criteria. METHODS: Forty-eight patients with probable PSP-Richardson's syndrome (PSP-RS), 30 with probable PSP-parkinsonism (PSP-P), 37 with Parkinson's disease (PD), and 38 controls were enrolled. For each functional domain, PSP patients were stratified by two certainty levels: vertical supranuclear gaze palsy (O1) and slowness of vertical saccades (O2) for ocular motor dysfunction; early unprovoked falls and tendency to fall on the pull-test for postural instability. Voxel-based morphometry (VBM), whole-brain fractional anisotropy (FA) and MR planimetric measurements were analysed and compared across patient groups. RESULTS: O1 was present in 64%, and O2 in 36% of all PSP patients. All PSP-RS patients showed early unprovoked falls. TBSS whole-brain analysis revealed that superior cerebellar peduncles (SCPs) were the only structures with significantly lower FA values in PSP-RS compared with PSP-P patients. PSP/O1 patients had lower FA values in midbrain than PSP/O2 patients. By contrast, VBM revealed no differences in grey matter volume between PSP patient groups. MR Planimetric measurements confirmed atrophy of midbrain and SCPs, in line with DTI findings. CONCLUSIONS: Our study demonstrates that SCPs were significantly more damaged in patients with PSP-RS in comparison with PSP-P patients, thus suggesting the role of SCPs in developing postural instability. Midbrain damage was less severe in O2 than in O1 patients, suggesting that the degree of vertical ocular dysfunction reflects the severity of midbrain atrophy.
INTRODUCTION: We investigated the imaging counterpart of two functional domains (ocular motor dysfunction and postural instability) in progressive supranuclear palsy (PSP) patients classified according to the new clinical diagnostic criteria. METHODS: Forty-eight patients with probable PSP-Richardson's syndrome (PSP-RS), 30 with probable PSP-parkinsonism (PSP-P), 37 with Parkinson's disease (PD), and 38 controls were enrolled. For each functional domain, PSPpatients were stratified by two certainty levels: vertical supranuclear gaze palsy (O1) and slowness of vertical saccades (O2) for ocular motor dysfunction; early unprovoked falls and tendency to fall on the pull-test for postural instability. Voxel-based morphometry (VBM), whole-brain fractional anisotropy (FA) and MR planimetric measurements were analysed and compared across patient groups. RESULTS:O1 was present in 64%, and O2 in 36% of all PSPpatients. All PSP-RSpatients showed early unprovoked falls. TBSS whole-brain analysis revealed that superior cerebellar peduncles (SCPs) were the only structures with significantly lower FA values in PSP-RS compared with PSP-Ppatients. PSP/O1patients had lower FA values in midbrain than PSP/O2patients. By contrast, VBM revealed no differences in grey matter volume between PSPpatient groups. MR Planimetric measurements confirmed atrophy of midbrain and SCPs, in line with DTI findings. CONCLUSIONS: Our study demonstrates that SCPs were significantly more damaged in patients with PSP-RS in comparison with PSP-Ppatients, thus suggesting the role of SCPs in developing postural instability. Midbrain damage was less severe in O2 than in O1patients, suggesting that the degree of vertical ocular dysfunction reflects the severity of midbrain atrophy.
Authors: Salvatore Nigro; Angelo Antonini; David E Vaillancourt; Klaus Seppi; Roberto Ceravolo; Antonio P Strafella; Antonio Augimeri; Andrea Quattrone; Maurizio Morelli; 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: 2020-02-24 Impact factor: 10.338
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