Table 2.
Clinicoradiologic data of patients who maintained initial diagnosis of Parkinson's disease (PD) at the end of follow‐up and of patients with initial diagnosis of PD at baseline who developed features (vertical gaze abnormalities) of progressive supranuclear palsy‐parkinsonism (PSP‐P) during the follow‐up
| Clinicoradiologic Data | PD | PSP‐P | ||||
|---|---|---|---|---|---|---|
| Baseline | 4‐year follow‐up | P valuea | Baseline | 4‐year follow‐up | P valueb | |
| n | 100 | 100 | \ | 10 | 10 | \ |
| Sex, no. M/F | 64/36 | 64/36 | \ | 9/1 | 9/1 | \ |
| Probable/possible PD level | 60/40 | 100/0 | \ | 10/0 | \ | \ |
| Age at examination, y, mean ± standard deviation (range) | 62.4 ± 8.0 (42‐80) | 66.4 ± 8.0 (46‐84) | \ | 69.0 ± 5.9 (61‐79) | 73.0 ± 5.9 (65‐83) | \ |
| Age at disease onset, y, mean ± standard deviation (range) | 58.1 ± 8.2 (40‐77) | 58.1 ± 8.2 (40‐77) | \ | 62.6 ± 5.7 (54‐70) | 62.6 ± 5.7 (54‐70) | \ |
| Disease duration, y, mean ± standard deviation (range) | 4.3 ± 3.9 (1‐24) | 8.3 ± 3.9 (5‐28) | \ | 6.4 ± 2.3 (3‐9) | 10.4 ± 2.3 (7‐13) | \ |
| Clinical features | ||||||
| Rest tremor, n (%) | 72 (72.0) | 73 (73.0) | 1c | 5 (50) | 1 (10) | .13c |
| Asymmetric motor symptoms, n (%)d | 69 (69.0) | 58 (58.0) | .003c | 5 (50) | 2 (20) | .25c |
| Vertical gaze abnormalities, n (%) | 0 (0) | 0 (0) | \ | 0 (0) | 10 (100) | .004c |
| MMSE score, median value (range) | 27 (16‐30) | 25 (13‐29) | <.001e | 27 (25‐30) | 20.5 (14‐26) | .009e |
| UPDRS‐ME score, median value (range) | 20 (8‐44) | 29.5 (18‐57) | <.001e | 27 (20‐29) | 37 (31‐43) | .006e |
| H‐Y score, median value (range) | 2 (1.5‐3) | 2 (2‐5) | .051e | 2 (2‐2) | 3 (2‐4) | .01e |
| Levodopa responsiveness, n (%)f | 81 (81.0) | 100 (100) | <.001c | 10 (100) | 1 (10) | .008c |
| Brain MRI measurements, mean ± standard deviation (range) | ||||||
| P/M | 3.78 ± 0.5 (2.67‐5.04) | 3.89 ± 0.5 (2.67‐5.08) | .77g | 4.71 ± 0.4 (4.17‐5.31) | 5.85 ± 0.8 (4.87‐7.19) | .001h |
| P/M 2.0 | 0.54 ± 0.2 (0.18‐0.93) | 0.59 ± 0.2 (0.23‐0.98) | .57g | 1.03 ± 0.1 (0.87‐1.19) | 1.37 ± 0.3 (1.01‐1.97) | .004h |
| MRPI | 8.98 ± 1.4 (6.19‐11.68) | 9.26 ± 1.4 (6.37‐11.87) | .40g | 10.81 ± 0.8 (9.89‐11.93) | 15.06 ± 1.4 (12.90‐18.10) | <.001h |
| MRPI 2.0 | 1.27 ± 0.4 (0.40‐2.10) | 1.40 ± 0.4 (0.60‐2.08) | .37g | 2.36 ± 0.2 (2.13‐2.71) | 3.51 ± 0.6 (2.88‐4.70) | <.001h |
PD, patients who maintained initial diagnosis of PD at the end of follow‐up; PSP‐P, patients with initial diagnosis of PD at baseline who developed vertical gaze abnormalities during the follow‐up; F, female; M, male; H‐Y, Hoehn and Yahr rating scale; P/M, pons/midbrain area ratio; MRPI, Magnetic Resonance Parkinsonism Index.
Clinicoradiological comparisons between baseline and follow‐up in PD patients.
Clinicoradiological comparisons between baseline and follow‐up in group PSP‐P patients.
McNemar's test.
Percentage of patients with UPDRS motor asymmetry index >2 points.
Wilcoxon signed rank test.
Number (percentage) of patients who showed a clinical improvement of 30% or greater in comparison with that detected in the off state. Of 40 patients with initial diagnosis of possible PD, 19 showed at baseline a levodopa responsiveness lower than 30%. These patients who have not had an adequate trial with levodopa o dopamine agonists developed a good response to levodopa at the end of follow‐up.
Repeated‐measures analysis of covariance, effect of time (baseline, follow‐up), with Bonferroni correction.
Paired t test with Bonferroni correction.