Önder Halil, Kocer Bilge, Turan Aynur, Kertmen Hayri, Comoglu Selcuk
Department of Neurology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
Department of Radiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
Ann Indian Acad Neurol. 2022 Nov-Dec;25(6):1087-1091. doi: 10.4103/aian.aian_208_22. Epub 2022 Nov 21.
The neuroimaging findings of brain stem atrophy resembling progressive supranuclear palsy (PSP) radiology are common in idiopathic normal pressure hydrocephalus (iNPH) subjects. Besides, recent studies report the existence of iNPH-like MRI findings in PSP subjects. We aimed to comparatively investigate the neuroimaging indices of iNPH and PSP in our patient groups in a detailed methodology.
Ultimately, 19 probable PSP patients and 18 patients with a definite diagnosis of iNPH were enrolled. The subjects were recruited retrospectively from those who had been admitted between 2017 and 2021 to the Movement Disorders Polyclinic and the Neurosurgery Clinic of the Diskapi Yildirim Beyazit Training and Education Hospital. MRI-based DESH score, Evans index, and the callosal angle (CA) have been calculated in all the individuals. Besides, quantitative MRI parameters of PSP were evaluated in every subject. Statistical analyses were performed using IBM SPSS Statistics 26.
The comparative analyses regarding the radiological parameters of PSP did not reveal any difference between patient groups. On the other hand, the comparisons of the neuroimaging parameters of iNPH, yielded differences in the CA, CA score, and the total DESH score. However, the ROC curve analyses did not reveal a discriminative power at a value of "very good" or "excellent" in any of the indices.
We found that the neuroimaging features of iNPH and PSP highly overlapped between these patient groups. These results may provide indirect evidence regarding the coexistence of PSP and iNPH pathophysiology that has been deliberated in several recent reports.
在特发性正常压力脑积水（iNPH）患者中，脑干萎缩的神经影像学表现类似于进行性核上性麻痹（PSP）的放射学表现很常见。此外，最近的研究报告称PSP患者中存在类似iNPH的MRI表现。我们旨在采用详细的方法对我们患者组中iNPH和PSP的神经影像学指标进行比较研究。
最终，纳入了19例可能的PSP患者和18例确诊为iNPH的患者。这些受试者是从2017年至2021年间入住迪斯卡皮·耶尔德勒姆·贝亚齐特培训和教育医院运动障碍综合门诊和神经外科门诊的患者中回顾性招募的。在所有个体中计算基于MRI的DESH评分、埃文斯指数和胼胝体角（CA）。此外，对每个受试者的PSP定量MRI参数进行了评估。使用IBM SPSS Statistics 26进行统计分析。
关于PSP放射学参数的比较分析未发现患者组之间存在任何差异。另一方面，iNPH神经影像学参数的比较显示，CA、CA评分和DESH总分存在差异。然而，ROC曲线分析在任何指标中均未显示出“非常好”或“优秀”值的鉴别能力。
我们发现iNPH和PSP的神经影像学特征在这些患者组之间高度重叠。这些结果可能为最近几份报告中讨论的PSP和iNPH病理生理学共存提供间接证据。
