Will Lee1,2. 1. Department of Neurosciences Box Hill Hospital Box Hill Victoria Australia. 2. Eastern Health Clinical School Monash University, Eastern Health Box Hill Victoria Australia.
Abstract
BACKGROUND: Numerous conventional magnetic resonance imaging (cMRI) parameters were previously found to differentiate parkinsonian disorders with statistical significance, but effect size has not been considered. OBJECTIVES: To quantify effect size of previously identified cMRI parameters that differentiated parkinsonian disorders with statistical significance. METHOD: A PubMed search limited to studies assessing cMRI parameters in at least 2 of Parkinson's disease, progressive supranuclear palsy, multiple system atrophy, and corticobasal degeneration/syndrome were selected. Either Cohen's d or positive and negative likelihood (LR+/-) as well as diagnostic odds ratios (DORs) were calculated as appropriate. cMRI parameter was considered useful if Cohen's d > 1.94 (<20% overlap) or if LR+ > 10, LR- < 0.1, or DOR > 20. RESULTS: Literature search identified 8848 publications and 36 were included for analysis. Putaminal (Cohen's d 2.07; DOR 23-infinity), pontine (DOR 32-infinity), and middle cerebellar peduncle (Cohen's d 2.24; DOR infinity) abnormalities were most useful in differentiating multiple system atrophy while reduced midbrain (Cohen's d 2.33-8.69; DOR infinity) and superior cerebellar peduncle (Cohen's d 2.47; DOR 51-infinity) diameters separated progressive supranuclear palsy. Corticobasal degeneration/syndrome does not have any distinguishing cMRI features, but reduced midbrain diameter may help differentiate corticobasal degeneration/syndrome from Parkinson's disease (DOR infinity). When LR- was calculated, all of these features carried a value of <0.1. CONCLUSION: A number of cMRI features consistently demonstrated large effect size in separating parkinsonian disorders. However, it is the presence and not absence of these cMRI features that is most useful in patients with low to moderate pretest probability.
BACKGROUND: Numerous conventional magnetic resonance imaging (cMRI) parameters were previously found to differentiate parkinsonian disorders with statistical significance, but effect size has not been considered. OBJECTIVES: To quantify effect size of previously identified cMRI parameters that differentiated parkinsonian disorders with statistical significance. METHOD: A PubMed search limited to studies assessing cMRI parameters in at least 2 of Parkinson's disease, progressive supranuclear palsy, multiple system atrophy, and corticobasal degeneration/syndrome were selected. Either Cohen's d or positive and negative likelihood (LR+/-) as well as diagnostic odds ratios (DORs) were calculated as appropriate. cMRI parameter was considered useful if Cohen's d > 1.94 (<20% overlap) or if LR+ > 10, LR- < 0.1, or DOR > 20. RESULTS: Literature search identified 8848 publications and 36 were included for analysis. Putaminal (Cohen's d 2.07; DOR 23-infinity), pontine (DOR 32-infinity), and middle cerebellar peduncle (Cohen's d 2.24; DOR infinity) abnormalities were most useful in differentiating multiple system atrophy while reduced midbrain (Cohen's d 2.33-8.69; DOR infinity) and superior cerebellar peduncle (Cohen's d 2.47; DOR 51-infinity) diameters separated progressive supranuclear palsy. Corticobasal degeneration/syndrome does not have any distinguishing cMRI features, but reduced midbrain diameter may help differentiate corticobasal degeneration/syndrome from Parkinson's disease (DOR infinity). When LR- was calculated, all of these features carried a value of <0.1. CONCLUSION: A number of cMRI features consistently demonstrated large effect size in separating parkinsonian disorders. However, it is the presence and not absence of these cMRI features that is most useful in patients with low to moderate pretest probability.
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