Wang Min, Lu Jiaying, Li Ling, Liu Fengtao, Jiao Fangyang, Wu Ping, Ge Jingjie, Wang Luyao, Brendel Matthias, Rominger Axel, Shi Kuangyu, Wang Jian, Zuo Chuantao, Jiang Jiehui
School of Life Sciences, Shanghai University, Shanghai, China.
Department of Nuclear Medicine & PET Center, National Clinical Research Center for Aging and Medicine, & National Center for Neurological Disorders, Huashan Hospital, Fudan University, Shanghai, China.
Eur Radiol. 2025 Feb 25. doi: 10.1007/s00330-025-11440-4.
Considerable evidence suggests that midbrain-based magnetic resonance Parkinsonism index (MRPI) measurements are reliable biomarkers for the diagnosis of progressive supranuclear palsy (PSP). However, the longitudinal atrophy pattern of PSP and potential differences in change rates among PSP phenotypic spectrum remain unclear. This study aims to investigate the longitudinal changes of MRPI measurements and explore their potential role in PSP phenotype progression monitoring.
Thirty-six patients with PSP-Richardson's syndrome (PSP-RS), 21 patients with variant PSP (vPSP), and 21 healthy controls (HCs) with longitudinal MRI and clinical follow-up were enrolled. Midbrain-based morphometric measurements and the corresponding annual percentage changes (APCs) were measured and further used to evaluate the associations with disease progression.
Significant differences in midbrain-based morphometric biomarkers were observed both at baseline and longitudinal trajectories between PSP and HC groups, but no significant differences were found between PSP-RS and vPSP subgroups. Baseline comprehensive measurements were significantly associated with the baseline PSP rating scale (PSPrs) in all PSP and PSP phenotypes. The APC of MRPI was significantly associated with the APC of PSPrs in all PSP (r = 0.267, p = 0.046) and the PSP-RS subgroup (r = 0.386, p = 0.020).
This study characterizes the longitudinal atrophy trajectory of PSP phenotypes and the significant associations between morphometric measurements and disease severity. Dissecting the causal associations among core 4R-tau, dopamine, and subsequent atrophy trajectories may enhance the application of these biomarkers for phenotype attribution.
Questions The use of midbrain-based MRPI measurements to assess the longitudinal prognosis of the PSP phenotype remains uncertain. Findings Significant differences in midbrain-based morphometric biomarkers were observed both at baseline and longitudinal trajectories between PSP and health control groups. Clinical relevance Midbrain-based morphometric measurements hold promise as potential radiological biomarkers for monitoring PSP disease progression and assessment.
大量证据表明，基于中脑的磁共振帕金森病指数（MRPI）测量是进行性核上性麻痹（PSP）诊断的可靠生物标志物。然而，PSP的纵向萎缩模式以及PSP表型谱中变化率的潜在差异仍不清楚。本研究旨在调查MRPI测量的纵向变化，并探讨其在PSP表型进展监测中的潜在作用。
纳入36例理查森综合征型PSP（PSP-RS）患者、21例变异型PSP（vPSP）患者和21例有纵向MRI及临床随访的健康对照（HC）。测量基于中脑的形态学指标及相应的年变化率（APC），并进一步用于评估与疾病进展的相关性。
在PSP组和HC组之间，基于中脑的形态学生物标志物在基线和纵向轨迹上均观察到显著差异，但PSP-RS和vPSP亚组之间未发现显著差异。在所有PSP及PSP表型中，基线综合测量与基线PSP评定量表（PSPrs）显著相关。在所有PSP（r = 0.267，p = 0.046）和PSP-RS亚组（r = 0.386，p = 0.020）中，MRPI的APC与PSPrs的APC显著相关。
本研究描述了PSP表型的纵向萎缩轨迹以及形态学测量与疾病严重程度之间的显著关联。剖析核心4R- tau、多巴胺和随后的萎缩轨迹之间的因果关联可能会增强这些生物标志物在表型归因中的应用。
问题 使用基于中脑的MRPI测量来评估PSP表型的纵向预后仍不确定。发现 在PSP组和健康对照组之间，基于中脑的形态学生物标志物在基线和纵向轨迹上均观察到显著差异。临床意义 基于中脑的形态学测量有望成为监测PSP疾病进展和评估的潜在影像学生物标志物。
