Gröschel Klaus, Hauser Till-Karsten, Luft Andreas, Patronas Nicholas, Dichgans Johannes, Litvan Irene, Schulz Jörg B
Department of General Neurology, and Hertie Institute for Clinical Brain Research, University of Tuebingen, Germany.
Neuroimage. 2004 Feb;21(2):714-24. doi: 10.1016/j.neuroimage.2003.09.070.
Because there are no biological markers for the clinical diagnosis of progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD), we established a mathematical model based on three-dimensional magnetic resonance (MR) imaging to differentiate between these parkinsonian disorders. Using MR imaging-based volumetry we studied the pattern of atrophic changes in patients with probable, possible or definite PSP (n = 33) or CBD (n = 18). Patients were compared with 22 controls with similar age. To establish a mathematical model that would allow for differentiation of PSP, CBD and controls we performed a discriminant analysis. We found a significant reduction in average brain, brainstem, midbrain and frontal gray matter volumes in patients with PSP, whereas patients with CBD showed atrophy of parietal cortex and corpus callosum. With the exception of reduced midbrain volumes in PSP, the measured volumes of anatomical structures showed an extensive overlap with the normal range on an individual basis. Using only post mortem confirmed cases of PSP (n = 8) and CBD (n = 7) as well as all controls, the volumes of midbrain, parietal white matter, temporal gray matter, brainstem, frontal white matter and pons were identified to separate best between groups and were used to construct a model with two canonical variables. This model allowed to correctly predict the diagnosis in 95% of controls as well as in 76% of all PSP and 83% of all CBD patients. Similar results were obtained only when patients with a possible and probable diagnosis of PSP and CBD, who were not involved in the development of the discriminant analysis, were classified. 3D-MR imaging-based volumetry may help to differentiate PSP from CBD ante mortem.
由于进行性核上性麻痹（PSP）和皮质基底节变性（CBD）的临床诊断尚无生物学标志物，我们建立了一种基于三维磁共振（MR）成像的数学模型，以区分这些帕金森氏症。我们使用基于MR成像的容积测定法，研究了可能、疑似或确诊的PSP患者（n = 33）或CBD患者（n = 18）的萎缩变化模式。将这些患者与22名年龄相仿的对照者进行比较。为了建立一个能够区分PSP、CBD和对照者的数学模型，我们进行了判别分析。我们发现PSP患者的平均脑体积、脑干、中脑和额叶灰质体积显著减少，而CBD患者表现为顶叶皮质和胼胝体萎缩。除PSP患者中脑体积减小外，所测量的解剖结构体积在个体层面上与正常范围有广泛重叠。仅使用尸检确诊的PSP病例（n = 8）和CBD病例（n = 7）以及所有对照者，确定中脑、顶叶白质、颞叶灰质、脑干、额叶白质和脑桥的体积在各组间区分效果最佳，并用于构建一个具有两个典型变量的模型。该模型能够正确预测95%的对照者以及76%的所有PSP患者和83%的所有CBD患者的诊断。仅对未参与判别分析建立过程的疑似和可能诊断为PSP和CBD的患者进行分类时，也获得了类似结果。基于三维MR成像的容积测定法可能有助于生前鉴别PSP和CBD。
