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| Pàgina inicial > Articles > Articles publicats > Diagnostic Accuracy of Magnetic Resonance Imaging Measures of Brain Atrophy Across the Spectrum of Progressive Supranuclear Palsy and Corticobasal Degeneration |
(Institut d'Investigació Biomèdica Sant Pau) (Memory and Aging Center. Department of Neurology. University of California) (Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas) (Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas) (Institut d'Investigació Biomèdica Sant Pau) (Institut d'Investigació Biomèdica Sant Pau) (Institut d'Investigació Biomèdica Sant Pau) (Institut d'Investigació Biomèdica Sant Pau) (Institut d'Investigació Biomèdica Sant Pau) (Department of Basic Medicine. Neuroscience. and Sense Organs. University of Bari Aldo Moro) (Memory and Aging Center. Department of Neurology. University of California) (University of California, San Francisco (UCSF)) (Memory and Aging Center. Department of Neurology. University of California)| Data: | 2022 |
| Resum: | Importance: The accurate diagnosis of progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) is hampered by imperfect clinical-pathological correlations. Objective: To assess and compare the diagnostic value of the magnetic resonance parkinsonism index (MRPI) and other magnetic resonance imaging-based measures of cerebral atrophy to differentiate between PSP, CBD, and other neurodegenerative diseases. Design, Setting, and Participants: This prospective diagnostic study included participants with 4-repeat tauopathies (4RT), PSP, CBD, other neurodegenerative diseases and available MRI who appeared in the University of California, San Francisco, Memory and Aging Center database. Data were collected from October 27, 1994, to September 29, 2019. Data were analyzed from March 1 to September 14, 2021. Main Outcomes and Measures: The main outcome of this study was the neuropathological diagnosis of PSP or CBD. The clinical diagnosis at the time of the MRI acquisition was noted. The imaging measures included the MRPI, cortical thickness, subcortical volumes, including the midbrain, pons, and superior cerebellar peduncle volumes. Multinomial logistic regression models (MLRM) combining different cortical and subcortical regions were defined to discriminate between PSP, CBD, and other pathologies. The areas under the receiver operating characteristic curves (AUROC) and cutoffs were calculated to differentiate between PSP, CBD, and other diseases. Results: Of the 326 included participants, 176 (54%) were male, and the mean (SD) age at MRI was 64. 1 (8. 0) years. The MRPI showed good diagnostic accuracy for the differentiation between PSP and all other pathologies (accuracy, 87%; AUROC, 0. 90; 95% CI, 0. 86-0. 95) and between 4RT and other pathologies (accuracy, 80%; AUROC, 0. 82; 95% CI, 0. 76-0. 87), but did not allow the discrimination of participants with CBD. Its diagnostic accuracy was lower in the subgroup of patients without the canonical PSP-Richardson syndrome (PSP-RS) or probable corticobasal syndrome (CBS) at MRI. MLRM combining cortical and subcortical measurements showed the highest accuracy for the differentiation between PSP and other pathologies (accuracy, 95%; AUROC, 0. 98; 95% CI, 0. 97-0. 99), CBD and other pathologies (accuracy, 83%; AUROC, 0. 86; 95% CI, 0. 81-0. 91), 4RT and other pathologies (accuracy, 89%; AUROC, 0. 94; 95% CI, 0. 92-0. 97), and PSP and CBD (accuracy, 91%; AUROC, 0. 95; 95% CI, 0. 91-0. 99), even in participants without PSP-RS or CBS at MRI. Conclusions and Relevance: In this study, the combination of widely available cortical and subcortical measures of atrophy on MRI discriminated between PSP, CBD, and other pathologies and could be used to support the diagnosis of 4RT in clinical practice. |
| Ajuts: | Instituto de Salud Carlos III JR20/0018 Instituto de Salud Carlos III FI18/00275 Instituto de Salud Carlos III PI21/00791 Instituto de Salud Carlos III PI14/01126 Instituto de Salud Carlos III PI17/01019 Instituto de Salud Carlos III PI17/01896 Instituto de Salud Carlos III PI20/01330 Instituto de Salud Carlos III AC19:00103 Agència de Gestió d'Ajuts Universitaris i de Recerca 2014SGR-0235 Agència de Gestió d'Ajuts Universitaris i de Recerca SLT006/17/00119 |
| Nota: | Altres ajuts: Global Brain Health Institute (GBHI), Alzheimer's Association, and Alzheimer's Society (GBHI ALZ UK-21-720973, AACSF-21-850193); NIH grants (AG019724, AG032306, AG045390, NS092089, AG045333, AG056749, AG062422, K24AG053435, K08AG052648, R01AG059794, R01AG056850-01A1, R21AG056974, R01AG061566, K23AG059888); Fondo de Investigaciones Sanitario; Centro de Investigación en Red-Enfermedades Neurodegenerativas program (Program 1, Alzheimer Disease); Fondo Europeo de Desarrollo Regional, Unión Europea, una manera de hacer Europa; La Marató de TV3 (20141210); Generalitat de Catalunya; Banco Bilbao Vizcaya Argentaria foundation. |
| Drets: | Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.  |
| Llengua: | Anglès |
| Document: | Article ; recerca ; Versió publicada |
| Matèria: | Atrophy ; Cerebellum ; Corticobasal Degeneration ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Neurodegenerative Diseases ; Prospective Studies ; Supranuclear Palsy, Progressive |
| Publicat a: | JAMA network open, Vol. 5 Núm. 4 (january 2022) , p. E229588, ISSN 2574-3805 |
