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

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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 languageEnglish
Pages (from-to)1856 - 1861
Number of pages6
JournalNeurology
Volume80
Issue number20
DOIs
Publication statusPublished - 2013

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