Singh-Reilly Neha, Blakey Morgan, Satoh Ryota, Ali Farwa, Pham Nha Trang Thu, Amrami Abigail, Stephens Yehkyoung C, Dickson Dennis W, Josephs Keith A, Whitwell Jennifer L
Department of Radiology, Mayo Clinic, 200 1 st St SW, Rochester, MN, 55905, USA.
Department of Neurology, Mayo Clinic, Rochester, MN, USA.
J Neurol. 2025 Jul 28;272(8):541. doi: 10.1007/s00415-025-13256-0.
The length of the tectal plate, which sits above the midbrain, is reduced in both the Richardson's syndrome (RS) and parkinsonism (P) variants of progressive supranuclear palsy (PSP). However, it is unclear whether tectal measurements could be useful biomarkers in other PSP variants or predict PSP pathology.
The Neurodegenerative Research Group, Mayo Clinic, enrolled 115 PSP (including seven variants), 19 corticobasal syndrome (CBS), 21 Parkinson's disease (PD), and 50 controls. Forty-seven PSP patients had PSP at autopsy, and 15 had a non-PSP pathology. Tectal plate length and area and area of the superior/inferior colliculi were measured. Measurements were compared across clinical and pathological groups, and associations were assessed with clinical severity. Effect sizes were evaluated using the area under the receiver operator characteristic curves (AUROCs).
All PSP variants showed reduced tectal plate length compared to controls, with good differentiation (AUROC > 0.80). Excellent differentiation was observed for PSP-RS and PSP-P from controls (AUROC = 0.93/0.86), and PD (AUROC = 0.92/0.83), and PSP-RS showed good differentiation from CBS (AUROC = 0.80). Tectal plate and superior colliculus areas were reduced in all PSP variants, except PSP-Speech-language (SL), compared to controls. PSP-RS and PSP-P showed reduced area measurements compared to PSP-SL. No differences were observed between PSP and non-PSP pathology. Reduced tectal plate length was associated with worse clinical severity in PSP.
Tectal plate length may have utility as a disease biomarker across PSP variants, although tectal plate measurements could not predict pathology within patients clinically diagnosed with PSP.
位于中脑上方的顶盖长度在进行性核上性麻痹（PSP）的理查森综合征（RS）和帕金森综合征（P）变体中均减小。然而，尚不清楚顶盖测量是否可作为其他PSP变体中的有用生物标志物或预测PSP病理。
梅奥诊所神经退行性疾病研究小组招募了115名PSP患者（包括7种变体）、19名皮质基底节综合征（CBS）患者、21名帕金森病（PD）患者和50名对照。47名PSP患者尸检确诊为PSP，15名患者有非PSP病理。测量顶盖长度、面积以及上/下丘面积。对各临床和病理组的测量结果进行比较，并评估与临床严重程度的相关性。使用受试者操作特征曲线下面积（AUROC）评估效应大小。
与对照组相比，所有PSP变体的顶盖长度均减小，具有良好的区分度（AUROC>0.80）。PSP-RS和PSP-P与对照组（AUROC=0.93/0.86）以及PD（AUROC=0.92/0.83）相比，区分度极佳，PSP-RS与CBS相比具有良好的区分度（AUROC=0.80）。与对照组相比，除PSP-语言（SL）外，所有PSP变体的顶盖和上丘面积均减小。与PSP-SL相比，PSP-RS和PSP-P的面积测量值减小。PSP与非PSP病理之间未观察到差异。顶盖长度减小与PSP患者更严重的临床严重程度相关。
顶盖长度可能作为PSP各变体的疾病生物标志物，尽管顶盖测量无法预测临床诊断为PSP的患者的病理情况。
