The midbrain to pons ratio: a simple and specific MRI sign of progressive supranuclear palsy

Luke A Massey; Hans R Jager; Dominic C Paviour; Sean S O'Sullivan; Helen Ling; David Williams; Constantinos Kallis; Janice L Holton; Tamas Revesz; David J Burn; Tarek Yousry; Andrew J Lees; Nick C Fox; Caroline Micallef

doi:10.1212/WNL.0b013e318292a2d2

The midbrain to pons ratio: a simple and specific MRI sign of progressive supranuclear palsy

Luke A Massey, Hans R Jager, Dominic C Paviour, Sean S O'Sullivan, Helen Ling, David Williams, Constantinos Kallis, Janice L Holton, Tamas Revesz, David J Burn, Tarek Yousry, Andrew J Lees, Nick C Fox, Caroline Micallef

Department of Neuroscience

Research output: Contribution to journal › Article › Research › peer-review

143 Citations (Scopus)

Abstract

MRI-based measurements used to diagnose progressive supranuclear palsy (PSP) typically lack pathologic verification and are not easy to use routinely. We aimed to develop in histologically proven disease a simple measure of the midbrain and pons on sagittal MRI to identify PSP. Methods: Measurements of the midbrain and pontine base on midsagittal T1-weighted MRI were performed in confirmed PSP (n = 12), Parkinson disease (n = 2), and multiple system atrophy (MSA) (n = 7), and in controls (n = 8). Using receiver operating characteristic curve analysis, cutoff values were applied to a clinically diagnosed cohort of 62 subjects that included PSP (n = 21), Parkinson disease (n = 10), MSA (n = 10), and controls (n = 21). Results: The mean midbrain measurement of 8.1 mm was reduced in PSP (p <0.001) with reduction in the midbrain to pons ratio (PSP smaller than MSA; p <0.001). In controls, the mean midbrain ratio was approximately two-thirds of the pontine base, in PSP it was

Original language	English
Pages (from-to)	1856 - 1861
Number of pages	6
Journal	Neurology
Volume	80
Issue number	20
DOIs	https://doi.org/10.1212/WNL.0b013e318292a2d2
Publication status	Published - 2013

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Massey, L. A., Jager, H. R., Paviour, D. C., O'Sullivan, S. S., Ling, H., Williams, D., Kallis, C., Holton, J. L., Revesz, T., Burn, D. J., Yousry, T., Lees, A. J., Fox, N. C., & Micallef, C. (2013). The midbrain to pons ratio: a simple and specific MRI sign of progressive supranuclear palsy. Neurology, 80(20), 1856 - 1861. https://doi.org/10.1212/WNL.0b013e318292a2d2

@article{3547f3ac73724bca857c7eed475a3a5b,

title = "The midbrain to pons ratio: a simple and specific MRI sign of progressive supranuclear palsy",

abstract = "MRI-based measurements used to diagnose progressive supranuclear palsy (PSP) typically lack pathologic verification and are not easy to use routinely. We aimed to develop in histologically proven disease a simple measure of the midbrain and pons on sagittal MRI to identify PSP. Methods: Measurements of the midbrain and pontine base on midsagittal T1-weighted MRI were performed in confirmed PSP (n = 12), Parkinson disease (n = 2), and multiple system atrophy (MSA) (n = 7), and in controls (n = 8). Using receiver operating characteristic curve analysis, cutoff values were applied to a clinically diagnosed cohort of 62 subjects that included PSP (n = 21), Parkinson disease (n = 10), MSA (n = 10), and controls (n = 21). Results: The mean midbrain measurement of 8.1 mm was reduced in PSP (p <0.001) with reduction in the midbrain to pons ratio (PSP smaller than MSA; p <0.001). In controls, the mean midbrain ratio was approximately two-thirds of the pontine base, in PSP it was",

author = "Massey, {Luke A} and Jager, {Hans R} and Paviour, {Dominic C} and O'Sullivan, {Sean S} and Helen Ling and David Williams and Constantinos Kallis and Holton, {Janice L} and Tamas Revesz and Burn, {David J} and Tarek Yousry and Lees, {Andrew J} and Fox, {Nick C} and Caroline Micallef",

year = "2013",

doi = "10.1212/WNL.0b013e318292a2d2",

language = "English",

volume = "80",

pages = "1856 -- 1861",

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TY - JOUR

T1 - The midbrain to pons ratio: a simple and specific MRI sign of progressive supranuclear palsy

AU - Massey, Luke A

AU - Jager, Hans R

AU - Paviour, Dominic C

AU - O'Sullivan, Sean S

AU - Ling, Helen

AU - Williams, David

AU - Kallis, Constantinos

AU - Holton, Janice L

AU - Revesz, Tamas

AU - Burn, David J

AU - Yousry, Tarek

AU - Lees, Andrew J

AU - Fox, Nick C

AU - Micallef, Caroline

PY - 2013

Y1 - 2013

N2 - MRI-based measurements used to diagnose progressive supranuclear palsy (PSP) typically lack pathologic verification and are not easy to use routinely. We aimed to develop in histologically proven disease a simple measure of the midbrain and pons on sagittal MRI to identify PSP. Methods: Measurements of the midbrain and pontine base on midsagittal T1-weighted MRI were performed in confirmed PSP (n = 12), Parkinson disease (n = 2), and multiple system atrophy (MSA) (n = 7), and in controls (n = 8). Using receiver operating characteristic curve analysis, cutoff values were applied to a clinically diagnosed cohort of 62 subjects that included PSP (n = 21), Parkinson disease (n = 10), MSA (n = 10), and controls (n = 21). Results: The mean midbrain measurement of 8.1 mm was reduced in PSP (p <0.001) with reduction in the midbrain to pons ratio (PSP smaller than MSA; p <0.001). In controls, the mean midbrain ratio was approximately two-thirds of the pontine base, in PSP it was

AB - MRI-based measurements used to diagnose progressive supranuclear palsy (PSP) typically lack pathologic verification and are not easy to use routinely. We aimed to develop in histologically proven disease a simple measure of the midbrain and pons on sagittal MRI to identify PSP. Methods: Measurements of the midbrain and pontine base on midsagittal T1-weighted MRI were performed in confirmed PSP (n = 12), Parkinson disease (n = 2), and multiple system atrophy (MSA) (n = 7), and in controls (n = 8). Using receiver operating characteristic curve analysis, cutoff values were applied to a clinically diagnosed cohort of 62 subjects that included PSP (n = 21), Parkinson disease (n = 10), MSA (n = 10), and controls (n = 21). Results: The mean midbrain measurement of 8.1 mm was reduced in PSP (p <0.001) with reduction in the midbrain to pons ratio (PSP smaller than MSA; p <0.001). In controls, the mean midbrain ratio was approximately two-thirds of the pontine base, in PSP it was

UR - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3908351/pdf/WNL205033.pdf

U2 - 10.1212/WNL.0b013e318292a2d2

DO - 10.1212/WNL.0b013e318292a2d2

M3 - Article

SN - 0028-3878

VL - 80

SP - 1856

EP - 1861

JO - Neurology

JF - Neurology

IS - 20

ER -

The midbrain to pons ratio: a simple and specific MRI sign of progressive supranuclear palsy

Abstract

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