title: MR parkinsonism index predicts vertical supranuclear gaze palsy in patients with PSP-parkinsonism.
abstract: OBJECTIVE
  To identify a biomarker for predicting the appearance of vertical supranuclear gaze palsy (VSGP) in patients affected by progressive supranuclear palsy-parkinsonism (PSP-P).
  
  
  METHODS
  Twenty-four patients with PSP-P were enrolled in the current study. Patients were clinically followed up every 6 months until the appearance of VSGP or the end of the follow-up (4 years). Participants underwent MRI at baseline and at the end of follow-up. Magnetic resonance parkinsonism index (MRPI), an imaging measure useful for diagnosing PSP, was calculated.
  
  
  RESULTS
  Twenty-one patients with PSP-P completed follow-up, and 3 patients dropped out. Eleven of 21 patients with PSP-P developed VSGP after a mean follow-up period of 28.5 months (range 6-48 months), while the remaining 10 patients with PSP-P did not develop VSGP during the 4-year follow-up period. At baseline, patients with PSP-P who later developed VSGP had MRPI values significantly higher than those of patients not developing VSGP without overlapping values between the 2 groups. MRPI showed a higher accuracy (100%) in predicting VSGP than vertical ocular slowness (accuracy 33.3%) or postural instability with or without vertical ocular slowness (accuracy 71.4% and 42.9%, respectively).
  
  
  CONCLUSIONS
  Our study demonstrates that MRPI accurately predicted, on an individual basis, the appearance of VSGP in patients with PSP-P, thus confirming clinical diagnosis in vivo.
authors: From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy. aldo.quattrone@gmail.com.
authors: Aldo
authors: A
authors: Quattrone
authors: From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy.
authors: Maurizio
authors: M
authors: Morelli
authors: From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy.
authors: David R
authors: DR
authors: Williams
authors: From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy.
authors: Basilio
authors: B
authors: Vescio
authors: From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy.
authors: Gennarina
authors: G
authors: Arabia
authors: From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy.
authors: Salvatore
authors: S
authors: Nigro
authors: From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy.
authors: Giuseppe
authors: G
authors: Nicoletti
authors: From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy.
authors: Maria
authors: M
authors: Salsone
authors: From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy.
authors: Fabiana
authors: F
authors: Novellino
authors: From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy.
authors: Rita
authors: R
authors: Nisticò
authors: From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy.
authors: Franco
authors: F
authors: Pucci
authors: From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy.
authors: Carmelina
authors: C
authors: Chiriaco
authors: From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy.
authors: Pierfrancesco
authors: P
authors: Pugliese
authors: From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy.
authors: Domenico
authors: D
authors: Bosco
authors: From the Institute of Neurology (A.Q., M.M., G.A., F.P.), Magna Graecia University, Catanzaro, Italy; Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology (A.Q., B.V., S.N., G.N., M.S., F.N., R.N., C.C., M.C.), National Research Council, Catanzaro, Italy; Department of Medicine (Neuroscience) (D.R.W.), Monash University, Melbourne, Australia; Neurology Unit (P.P.), Annunziata Hospital, Cosenza, Italy; and Department of Neuroscience (D.B.), San Giovanni di Dio Hospital, Crotone, Italy.
authors: Manuela
authors: M
authors: Caracciolo
mesh_terms: D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D015588:Observer Variation; D015835:Ocular Motility Disorders / Q000000981:diagnostic imaging* / Q000188:drug therapy; D020734:Parkinsonian Disorders / Q000000981:diagnostic imaging* / Q000188:drug therapy; D011379:Prognosis; D013494:Supranuclear Palsy, Progressive / Q000000981:diagnostic imaging* / Q000188:drug therapy