title: MRI measurements of brainstem structures in patients with vascular parkinsonism, progressive supranuclear palsy, and Parkinson's disease.
abstract: Magnetic resonance (MR) measurements of brainstem structures have been reported to be useful in differentiating patients with progressive supranuclear palsy (PSP) from those with Parkinson's disease (PD). The aim of this study was to determine whether quantitative measurements of brainstem structures on MR images can help differentiate vascular parkinsonism (VaP) from degenerative parkinsonism (PD and PSP). Areas of the midbrain and pons, and widths of the superior cerebellar peduncle (SCP) and middle cerebellar peduncle (MCP) were measured in 62 patients with PD, 25 patients with PSP (11 probable and 14 possible), and 24 patients with VaP on T1-weighted MR images. The midbrain-to-pons area ratio (M/P ratio), MCP-to-SCP width ratio (MCP/SCP ratio), and MR parkinsonism index (MRPI; P/M × MCP/SCP) were calculated. The midbrain area and M/P ratio of patients with VaP (104 and 0.22 mm2, respectively) were smaller than those in patients with PD (121 and 0.24 mm2, respectively) and larger than those in patients with PSP (90 and 0.19 mm2, respectively). The MRPI was significantly larger in patients with PSP (13.6) in comparison with those with PD (10.1) and VaP (10.7). However, the MRPI of patients with VaP was not significantly different from patients with PD. Our study showed that MRPI was useful in differentiating PSP from VaP or PD. Thus, MR imaging measurements of brainstem structures may help differentiate patients with VaP from those with PD and PSP.
authors.affiliation: Department of Neurology, Chonnam National University Hospital, Gwangju, Korea.|National Research Center for Dementia, Gwangju, Korea.
authors.forename: Byeong C
authors.initials: BC
authors.lastname: Kim
authors.affiliation: Department of Neurology, Chonnam National University Hospital, Gwangju, Korea. drchoism@gmail.com.|National Research Center for Dementia, Gwangju, Korea. drchoism@gmail.com.|Department of Neurology, Chonnam National University Medical School, 160, Baekseo-ro, Dong-gu, Gwangju, 61469, Korea. drchoism@gmail.com.
authors.forename: Seong-Min
authors.identifier: http://orcid.org/0000-0003-3138-1881
authors.initials: SM
authors.lastname: Choi
authors.affiliation: Department of Neurology, Chonnam National University Hwasun Hospital, Hwasun, Korea.
authors.forename: Kang-Ho
authors.initials: KH
authors.lastname: Choi
authors.affiliation: Department of Neurology, Chonnam National University Hwasun Hospital, Hwasun, Korea.
authors.forename: Tai-Seung
authors.initials: TS
authors.lastname: Nam
authors.affiliation: Department of Neurology, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Joon-Tae
authors.initials: JT
authors.lastname: Kim
authors.affiliation: Department of Neurology, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Seung-Han
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Neurology, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Man-Seok
authors.initials: MS
authors.lastname: Park
authors.affiliation: Department of Radiology, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Woong
authors.initials: W
authors.lastname: Yoon
mesh_terms: D000368:Aged; D001933:Brain Stem / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009929:Organ Size; D020734:Parkinsonian Disorders / Q000000981:diagnostic imaging*; D013494:Supranuclear Palsy, Progressive / Q000000981:diagnostic imaging*
keywords: Brainstem; MRI; Parkinson’s disease; Progressive supranuclear palsy; Vascular parkinsonism