Andrea Quattrone1, Angelo Antonini2, David E Vaillancourt3,4, Klaus Seppi5,6, Roberto Ceravolo7, Antonio P Strafella8, Maurizio Morelli1, Salvatore Nigro9, Basilio Vescio10, Maria G Bianco11, Roberta Vasta9, Pier Paolo Arcuri12, Luca Weis13, Eleonora Fiorenzato13, Roberta Biundo13, Roxana G Burciu14, Florian Krismer5, Nikolaus R McFarland4, Christoph Mueller5, Elke R Gizewski6,15, Mirco Cosottini16, Eleonora Del Prete7, Sonia Mazzucchi7, Aldo Quattrone9,17. 1. Institute of Neurology, University "Magna Graecia", Catanzaro, Italy. 2. Department of Neuroscience, University of Padua, Padua, Italy. 3. Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, USA. 4. Department of Neurology and Biomedical Engineering, University of Florida, Gainesville, Florida, USA. 5. Department of Neurology, Medical University Innsbruck, Innsbruck, Austria. 6. Neuroimaging Core Facility, Medical University Innsbruck, Innsbruck, Austria. 7. Department of Clinical and Experimental Medicine, Unit of Neurology, University of Pisa, Pisa, Italy. 8. Krembil Research Institute, UHN & Research Imaging Centre, Campbell Family Mental Health Research Institute, CAMH, University of Toronto, Toronto, Ontario, Canada. 9. Neuroscience Research Center, University "Magna Graecia", Catanzaro, Italy. 10. Biotecnomed S.C.aR.L, Catanzaro, Italy. 11. Department of Health Sciences, Magna Graecia University, Catanzaro, Italy. 12. Department of Radiology, Pugliese-Ciaccio Hospital, Catanzaro, Italy. 13. IRCCS San Camillo Hospital, Venice, Italy. 14. Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware, USA. 15. Department of Neuroradiology, Medical University Innsbruck, Innsbruck, Austria. 16. Department of Translational Research and New Technologies, University of Pisa, Pisa, Italy. 17. Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Catanzaro, Italy.
Abstract
BACKGROUND: Enlargement of the third ventricle has been reported in atypical parkinsonism. We investigated whether the measurement of third ventricle width could distinguish Parkinson's disease (PD) from progressive supranuclear palsy (PSP). METHODS: We assessed a new MR T1-weighted measurement (third ventricle width/internal skull diameter) in a training cohort of 268 participants (98 PD, 73 PSP, 98 controls from our center) and in a testing cohort of 291 participants (82 de novo PD patients and 133 controls from the Parkinson's Progression Markers Initiative, 76 early-stage PSP from an international research group). PD diagnosis was confirmed after a 4-year follow-up. Diagnostic performance of the third ventricle/internal skull diameter was assessed using receiver operating characteristic curve with bootstrapping; the area under the curve of the training cohort was compared with the area under the curve of the testing cohort using the De Long test. RESULTS: In both cohorts, third ventricle/internal skull diameter values did not differ between PD and controls but were significantly lower in PD than in PSP patients (P < 0.0001). In PD, third ventricle/internal skull diameter values did not change significantly between baseline and follow-up evaluation. Receiver operating characteristic analysis accurately differentiated PD from PSP in the training cohort (area under the curve, 0.94; 95% CI, 91.1-97.6; cutoff, 5.72) and in the testing cohort (area under the curve, 0.91; 95% CI, 87.0-97.0; cutoff,: 5.88), validating the generalizability of the results. CONCLUSION: Our study provides a new reliable and validated MRI measurement for the early differentiation of PD and PSP. The simplicity and generalizability of this biomarker make it suitable for routine clinical practice and for selection of patients in clinical trials worldwide.
BACKGROUND: Enlargement of the third ventricle has been reported in atypical parkinsonism. We investigated whether the measurement of third ventricle width could distinguish Parkinson's disease (PD) from progressive supranuclear palsy (PSP). METHODS: We assessed a new MR T1-weighted measurement (third ventricle width/internal skull diameter) in a training cohort of 268 participants (98 PD, 73 PSP, 98 controls from our center) and in a testing cohort of 291 participants (82 de novo PDpatients and 133 controls from the Parkinson's Progression Markers Initiative, 76 early-stage PSP from an international research group). PD diagnosis was confirmed after a 4-year follow-up. Diagnostic performance of the third ventricle/internal skull diameter was assessed using receiver operating characteristic curve with bootstrapping; the area under the curve of the training cohort was compared with the area under the curve of the testing cohort using the De Long test. RESULTS: In both cohorts, third ventricle/internal skull diameter values did not differ between PD and controls but were significantly lower in PD than in PSPpatients (P < 0.0001). In PD, third ventricle/internal skull diameter values did not change significantly between baseline and follow-up evaluation. Receiver operating characteristic analysis accurately differentiated PD from PSP in the training cohort (area under the curve, 0.94; 95% CI, 91.1-97.6; cutoff, 5.72) and in the testing cohort (area under the curve, 0.91; 95% CI, 87.0-97.0; cutoff,: 5.88), validating the generalizability of the results. CONCLUSION: Our study provides a new reliable and validated MRI measurement for the early differentiation of PD and PSP. The simplicity and generalizability of this biomarker make it suitable for routine clinical practice and for selection of patients in clinical trials worldwide.
Authors: Gabriella King; Kaliana M Veros; Duncan Archibald Allan MacLaren; Martin Peter Konrad Leigh; Joseph A Spernyak; Stewart D Clark Journal: Eur J Neurosci Date: 2021-11-02 Impact factor: 3.698
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