Institute of Neurology, University Magna Graecia, Germaneto, Catanzaro, Italy.
Neurology. 2011 Sep 13;77(11):1042-7. doi: 10.1212/WNL.0b013e31822e55d0. Epub 2011 Aug 10.
Magnetic resonance parkinsonism index (MRPI) has been proposed as a powerful tool to discriminate patients with progressive supranuclear palsy (PSP) from those with Parkinson disease (PD) or other parkinsonisms, on an individual basis. We investigated the usefulness of MRPI in predicting the clinical evolution in PSP of patients with clinically unclassifiable parkinsonism (CUP), i.e., parkinsonism not fulfilling the established clinical diagnostic criteria for any parkinsonian disorders, using a cohort study.
Forty-five patients with CUP underwent baseline clinical evaluation and MRI with calculation of MRPI. All patients were divided in 2 groups according to MRPI values. A group included 30 patients with CUP with normal MRPI values while the other group included 15 patients with CUP with MRPI values suggestive of PSP (higher than 13.55). A clinical follow-up was performed in all patients.
Duration of clinical follow-up in these 2 groups was 28.4 ± 11.7 months (mean ± SD). None of the patients with CUP with normal MRPI values fulfilled established clinical criteria for PSP (follow-up ranging from 24 to 60 months). By contrast, 11 of 15 patients with CUP with abnormal MRPI values (higher than 13.55) developed during the follow-up (range from 6 to 48 months) additional clinical features characteristic of probable (1 patient) or possible (10 patients) PSP. MRPI showed a higher accuracy in predicting PSP (92.9%) than clinical features, such as vertical ocular slowness or first-year falls (61.9% and 73.8%, respectively).
Our findings suggest that MRPI is more powerful than clinical features in predicting the evolution of CUP toward PSP phenotypes.
磁共振帕金森病指数（MRPI）已被提议作为一种强大的工具，用于在个体基础上区分进行性核上性麻痹（PSP）患者与帕金森病（PD）或其他帕金森病患者。我们通过一项队列研究，研究了 MRPI 在预测临床上无法分类的帕金森病（CUP）患者的 PSP 临床演变中的作用，即不符合任何帕金森病临床诊断标准的帕金森病，即帕金森病。
45 例 CUP 患者接受了基线临床评估和 MRI 检查，并计算了 MRPI 值。所有患者均根据 MRPI 值分为 2 组。一组包括 30 例 CUP 患者，MRPI 值正常，另一组包括 15 例 CUP 患者，MRPI 值提示 PSP（高于 13.55）。对所有患者进行临床随访。
这两组的临床随访时间分别为 28.4±11.7 个月（均值±标准差）。MRPI 值正常的 CUP 患者中，无一例符合 PSP 的既定临床标准（随访时间为 24 至 60 个月）。相比之下，15 例 MRPI 值异常（高于 13.55）的 CUP 患者中有 11 例在随访期间（6 至 48 个月）出现了可能（1 例）或可能（10 例）的 PSP 额外临床特征。MRPI 在预测 PSP（92.9%）方面的准确性高于垂直眼球运动缓慢或第一年跌倒等临床特征（分别为 61.9%和 73.8%）。
我们的研究结果表明，MRPI 比临床特征更能预测 CUP 向 PSP 表型的演变。
