Table 2.
Magnetic resonance findings in progressive supranuclear palsy.
| Imaging biomarker | Findings | Performance (sensitivity/specificity, AUC) | References |
|---|---|---|---|
| MIDBRAIN | |||
| Hummingbird/penguin sign | Flat or concave superior profile in sagittal images | 51.6/88.8% | Mueller et al. (87) |
| 68/88.8% | Righini et al. (44) | ||
| Morning glory sign | Concavity of the lateral margin of the midbrain on axial images | 36.8/97.7% | Mueller et al. (87) |
| Anteroposterior diameter | <8.9 vs. PD and MSA | 90/90%, AUC 0.94 | Mangesius et al. (43) |
| <12 mm vs. PD | Righini et al. (44) | ||
| Sagittal area | <122 mm2 vs. PD | 83/84% | Moller et al. (45) |
| <117 mm2 vs. MSA-P | 76/82% | ||
| <114 mm2 vs. MSA-C | 74/81% | ||
| Midbrain/pons ratio | <0.18 vs. PD and MSA | 81/87% | Mangesius et al. (43) |
| <0.215 vs. PD and MSA-P | 76.4/80% | Moller et al. (45) | |
| <0.275 vs. MSA-C | 96.2/81% | Moller et al. (45) | |
| MRPI | >13.6 vs. PD and HC | 100/100% | Quattrone et al. (46) |
| >12.9 vs. MSA-P | 100/100% | Quattrone et al. (46) | |
| MRPI 2.0 | >2.5 vs. PD and HC | 100/100% | Quattrone et al. (85) |
| FLAIR signal | Increased vs. PD | 28/100% | Righini et al. (44) |
| Diffusivity | Increased vs. PD and MSA-P | 81/81%, AUC: 0.90 | Surova et al. (62) |
| Tsukamoto et al. (63) | |||
| SUPERIOR CEREBELLAR PEDUNCLES | |||
| Volume | Reduced vs. PD and MSA | 74/94% | Paviour et al. (88) |
| Quattrone et al. (46) | |||
| FLAIR signal | Increased | 19.6/100% | Kataoka et al. (89) |
| Diffusivity | Increased | ||
| • vs. PD | 100/100% | Nicoletti et al. (90) | |
| • vs. MSA-P | 96.4/93.3% | ||
| PUTAMEN | |||
| Volume | Reduced vs. PD | AUC: 0.93 | Pyatigorskaya et al. (18) |
| Messina et al. (48) | |||
| Diffusivity | Increased vs. PD | 75/100% | Nicoletti et al. (58) |
| 90/100% | Schocke et al. (91) | ||
| Susceptibility, R2* | Increased vs. PD | AUC: 0.83 | Sjöstrom et al. (74) |
| Lee et al. (77) | |||
| THALAMUS | |||
| Volume | Decreased vs. PD and MSA-P | AUC: 0.86 | Pyatigorskaya et al. (18) |
| Messina et al. (48) | |||
| Surova et al. (62) | |||
| Diffusivity | Increased vs. PD and MSA-P | 81/77%, AUC: 0.81 | Surova et al. (62) |
| GLOBUS PALLIDUS | |||
| Volume | Decreased vs. PD and MSA-P | AUC: 0.86 | Lee et al. (77) |
| Messina et al. (48) | |||
| Surova et al. (62) | |||
| Diffusivity | Increased | ——– | Nicoletti et al. (58) |
| Seppi et al. (92) | |||
| Schocke et al. (91) | |||
| Susceptibility | Increased | Sjöstrom et al. (74) | |
| • vs. PD | AUC: 0.75 | ||
| • vs. MSA | AUC: 0.73 | ||
| RED NUCLEUS | |||
| Susceptibility | Increased | Sjöstrom et al. (74) | |
| • vs. PD | AUC: 0.97 | ||
| • vs. MSA | AUC: 0.75 | ||
| CORTICAL REGIONS | |||
| Frontal cortex | Atrophic | ——– | Worker et al. (93) |
| Huppertz et al. (94) | |||
The table provides optimal cut-off points with the corresponding sensitivity and specificity, as proposed by the studies. AUC values were reported when available. These values depend on which disease groups are compared. They were not validated and may vary from one study to another. The patient characteristics for each reference are listed in the Supplementary Table.
AUC, area under the ROC curve; DP, proton density-weighted; HC, healthy controls; MRPI, Magnetic Resonance Parkinsonism Index; MSA, multiple system atrophy; MSA-C, cerebellar variant of MSA; MSA-P, Parkinsonian variant of MSA; PD, Parkinson's disease; PSP-RS, progressive supranuclear palsy with Richardson syndrome; SWI, susceptibility-weighted imaging.