A novel diagnostic marker for progressive supranuclear palsy targeting atrophy of the subthalamic nucleus

Shinsuke Fujioka; Takashi Morishita; Koichi Takano; Nobutaka Takahashi; Kanako Kurihara; Akihiro Nishida; Takayasu Mishima; Midori Suenaga; Yoichi Matsunaga; Yoshi Tsuboi

doi:10.1016/j.jns.2021.117366

A novel diagnostic marker for progressive supranuclear palsy targeting atrophy of the subthalamic nucleus

J Neurol Sci. 2021 Apr 15:423:117366. doi: 10.1016/j.jns.2021.117366. Epub 2021 Feb 23.

Authors

Affiliations

¹ Department of Neurology, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, Japan. Electronic address: shinsuke@cis.fukuoka-u.ac.jp.
² Department of Neurosurgery, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, Japan. Electronic address: tmorishita@fukuoka-u.ac.jp.
³ Department of Radiology, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, Japan. Electronic address: t-takano@fukuoka-u.ac.jp.
⁴ Department of Neurology, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, Japan.
⁵ Department of Neurology, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, Japan. Electronic address: kanakon@fukuoka-u.ac.jp.
⁶ Department of Neurology, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, Japan. Electronic address: mishima1006@fukuoka-u.ac.jp.
⁷ Department of Pharmaceutical Science, Tokushima Bunri University, 180 Nishihama, Yamashiro-cho, Tokushima, Japan. Electronic address: msuenaga@ph.bunri-u.ac.jp.
⁸ Department of Neurosurgery, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, Japan. Electronic address: yoichima@fukuoka-u.ac.jp.
⁹ Department of Neurology, Fukuoka University, 7-45-1, Nanakuma, Jonan-ku, Fukuoka, Japan. Electronic address: tsuboi@cis.fukuoka-u.ac.jp.

PMID: 33714084
DOI: 10.1016/j.jns.2021.117366

Abstract

Introduction: Despite great progress in radiological diagnostic tools for neurodegenerative disorders, their diagnostic accuracy has been unsatisfactory. One of the pathological hallmarks of progressive supranuclear palsy (PSP) is atrophy of the subthalamic nucleus, which has not attracted much attention for imaging analysis.

Methods: The clinical data of patients with PSP, multiple system atrophy (MSA), Parkinson's disease (PD), and corticobasal syndrome (CBS) who underwent brain magnetic resonance imaging at our department between June 2019 and March 2020 were retrospectively reviewed. The volumes of the subthalamic nucleus and of the whole cerebrum were then analyzed and compared among the disorders.

Results: Fourteen PSP-Richardson syndrome (RS), 14 MSA, 14 PD, and 8 CBS patients were assessed. The mean volume of the bilateral subthalamic nuclei was smaller in PSP patients (0.148 ± 0.012 cm³) than in MSA (0.183 ± 0.026 cm³; p < 0.001), PD (0.209 ± 0.031 cm³; p < 0.001), and CBS (0.180 ± 0.056 cm³; p < 0.001) patients. The volume of the whole cerebrum was not significantly different among the disorders. Using an STN volume cut-off of 0.01925, the sensitivity and specificity for differential diagnosis between PSP and the other disorders were 0.846 and 0.972, respectively.

Conclusion: Subthalamic nucleus volume may be a useful diagnostic marker for PSP; it may easily differentiate it from other neurodegenerative parkinsonian disorders.

Keywords: Atrophy; Magnetic resonance imaging; Neurodegenerative disorders; Progressive supranuclear palsy; Subthalamic nucleus.

MeSH terms

Atrophy
Diagnosis, Differential
Humans
Magnetic Resonance Imaging
Multiple System Atrophy* / diagnostic imaging
Retrospective Studies
Subthalamic Nucleus*
Supranuclear Palsy, Progressive* / diagnostic imaging