Department of Neurology, Mayo Clinic Rochester, Rochester, Minnesota, USA.
Department of Biostatistics, Mayo Clinic Rochester, Rochester, Minnesota, USA.
Mov Disord. 2019 Aug;34(8):1144-1153. doi: 10.1002/mds.27619. Epub 2019 Feb 6.
In 2017, the International Parkinson and Movement Disorder Society put forward new clinical criteria for the diagnosis of PSP, recognizing diverse PSP phenotypes. In this study, we compared the sensitivity and specificity of the new criteria with the National Institutes of Neurological Disease and Society for Progressive Supranuclear Palsy criteria at different times.
Patients with clinical parkinsonism, clinical and/or neuropathological diagnosis of PSP, were identified from the Society for Progressive Supranuclear Palsy brain bank. All patients had neuropathologic diagnoses and detailed clinical examination performed by a neurologist at 1 of the 3 Mayo Clinic sites, in Florida, Arizona, and Minnesota. Clinical symptoms and signs were abstracted retrospectively in a blinded fashion and used to determine whether patients met either diagnostic criterion. Patients were divided into early and late disease stage groups using a 3-year cutoff.
A total of 129 patients were included, of whom 66 had PSP pathology (51%). The remainder had other neurodegenerative diseases. The overall sensitivity of the International Parkinson and Movement Disorder Society criteria was 87.9%, compared with 45.5% for the National Institutes of Neurological Disease and Society for Progressive Supranuclear Palsy criteria, whereas the specificity of the International Parkinson and Movement Disorder Society probable PSP criteria was 85.7%, compared with 90.5% for the National Institutes of Neurological Disease and Society for Progressive Supranuclear Palsy. Individual patients were noted to have features of multiple PSP phenotypes.
The International Parkinson and Movement Disorder Society criteria recognize several phenotypes of progressive supranuclear palsy and hence have higher sensitivity than the previous criteria. © 2019 International Parkinson and Movement Disorder Society.
2017 年，国际帕金森病和运动障碍学会提出了 PSP 的新临床诊断标准，承认 PSP 具有多种表型。本研究比较了新诊断标准与国立神经病学与卒中研究所-进行性核上性麻痹（National Institutes of Neurological Disease and Society for Progressive Supranuclear Palsy，NINDS-SSP）标准在不同时间的敏感性和特异性。
从进行性核上性麻痹脑库中确定具有临床帕金森病、临床和/或神经病理学 PSP 诊断的患者。所有患者均经神经病理学诊断，并由佛罗里达州、亚利桑那州和明尼苏达州的 3 个 Mayo 诊所的神经病学家进行详细的临床检查。以盲法回顾性提取临床症状和体征，并用于确定患者是否符合任一诊断标准。根据 3 年的截止时间，将患者分为早期和晚期疾病阶段组。
共纳入 129 例患者，其中 66 例（51%）患者具有 PSP 病理学。其余患者患有其他神经退行性疾病。国际帕金森病和运动障碍学会标准的总体敏感性为 87.9%，而国立神经病学与卒中研究所-进行性核上性麻痹标准为 45.5%，国际帕金森病和运动障碍学会可能的 PSP 标准的特异性为 85.7%，而国立神经病学与卒中研究所-进行性核上性麻痹标准为 90.5%。个别患者表现出多种 PSP 表型的特征。
国际帕金森病和运动障碍学会标准认识到进行性核上性麻痹的几种表型，因此其敏感性高于以前的标准。© 2019 国际帕金森病和运动障碍学会。
