Manual MRI morphometry in Parkinsonian syndromes.
Several morphometric magnetic resonance imaging parameters may serve for differential diagnosis of parkinsonism. The objective of this study was to identify which performs best in clinical routine.



We acquired multicentric magnetization-prepared rapid gradient echo sequences in patients with Parkinson's disease (n=204), progressive supranuclear palsy (n=106), multiple system atrophy-cerebellar, (n = 21); multiple system atrophy-parkinsonian (n = 60), and healthy controls (n = 73), performed manual planimetric measurements, and calculated receiver operator characteristics with leave-one-out cross-validation to propose cutoff values.



The midsagittal midbrain area was reduced in PSP versus all other groups (P < 0.001). The midsagittal pons area was reduced in MSA-cerebellar, MSA-parkinsonian, and PSP versus PD patients and healthy controls (P < 0.001). The midbrain/pons area ratio was lower in PSP (P < 0.001) and higher in MSA-cerebellar and MSA-parkinsonian versus PD and PSP (P < 0.001).



The midsagittal midbrain area most reliably identified PSP, the midsagittal pons area MSA-cerebellar. The midbrain/pons area ratio differentiated MSA-cerebellar and PSP better than the magnetic resonance-Parkinson index. © 2017 International Parkinson and Movement Disorder Society.
Department of Neurology, Philipps University Marburg, Marburg, Germany.
Leona
L
Möller
Department of Neurology, University of Ulm, Ulm, Germany.
Jan
J
Kassubek
Institute of Clinical Neuroscience and Medical Psychology, and Department of Neurology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.|Klinikum Ernst von Bergmann, Potsdam, Germany.
Martin
M
Südmeyer
Departement of Neurology, Johann Wolfgang Goethe University, Frankfurt, Germany.
Rüdiger
R
Hilker
Department of Neuroradiology, Johann Wolfgang Goethe University, Frankfurt, Germany.
Elke
E
Hattingen
Department of Neuroradiology, Medical University Center Freiburg, Freiburg, Germany.
Karl
K
Egger
Department of Neurology, Medical University Center Freiburg, Freiburg, Germany.
Florian
F
Amtage
Department of Neurology, University of Ulm, Ulm, Germany.
Elmar H
EH
Pinkhardt
Department of Neurology, Philipps University Marburg, Marburg, Germany.|Department of Neurology, Technische Universität München, Munich, Germany.|German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
Gesine
G
Respondek
Department of Neurology, Philipps University Marburg, Marburg, Germany.|Parkinson's Disease and Movement Disorders Department, HYGEIA Hospital, Athens, Greece and Second Dept. of Neurology, Attikon Hospital, University of Athens Greece.
Maria
0000-0003-1668-9925
M
Stamelou
Department of Children and Youth Medicine, Philipps University Marburg, Marburg, Germany.
Franz
F
Möller
Institute of Clinical Neuroscience and Medical Psychology, and Department of Neurology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
Alfons
0000-0002-6414-7939
A
Schnitzler
Department of Neurology, Philipps University Marburg, Marburg, Germany.
Wolfgang H
WH
Oertel
Department of Neurology, Philipps University Marburg, Marburg, Germany.
Susanne
S
Knake
Swiss Epilepsy Center, Zurich, Switzerland.
Hans-Jürgen
HJ
Huppertz
Department of Neurology, Philipps University Marburg, Marburg, Germany.|Department of Neurology, Medical University Center Freiburg, Freiburg, Germany.|Department of Neurology, Technische Universität München, Munich, Germany.
Günter U
GU
Höglinger
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000000981:diagnostic imaging* / Q000503:physiopathology; D010300:Parkinson Disease / Q000000981:diagnostic imaging*; D020734:Parkinsonian Disorders / Q000000981:diagnostic imaging / Q000503:physiopathology; D012372:ROC Curve; D015203:Reproducibility of Results; D013494:Supranuclear Palsy, Progressive / Q000000981:diagnostic imaging*
Parkinson's disease; magnetic resonance imaging; morphometry; multiple system atrophy; progressive supranuclear palsy