Top

Published in:

01-12-2020 | Hydrocephalus | Diagnostic Neuroradiology

Magnetic resonance parkinsonism indices and interpeduncular angle in idiopathic normal pressure hydrocephalus and progressive supranuclear palsy

Authors: Lorenzo Ugga, Renato Cuocolo, Sirio Cocozza, Giuseppe Pontillo, Andrea Elefante, Mario Quarantelli, Caterina Vicidomini, Maria Francesca De Pandis, Giovanna De Michele, Alessandra D’Amico, Oreste de Divitiis, Arturo Brunetti

Published in: Neuroradiology | Issue 12/2020

Abstract

Purpose

The clinical presentation of idiopathic normal pressure hydrocephalus (iNPH) may overlap with progressive supranuclear palsy (PSP). The Magnetic Resonance Parkinsonism Index (MRPI), MRPI 2.0, and the interpeduncular angle (IPA) have been investigated to differentiate PSP from healthy controls (HC) and other parkinsonisms. We aimed to assess equivalences and differences in MRPI, MRPI 2.0, and IPA in iNPH, PSP, and HC groups.

Methods

We retrospectively recruited 99 subjects (30 iNPH, 32 PSP, 37 HC) from two institutions. MRI exams, acquired on either 1.5 T or 3 T scanners, included 3D T1-weighted images to measure MRPI, MRPI 2.0, and IPA. Inter- and intra-rater reliability was investigated with the intra-class correlation coefficient (ICC), and the two one-sided t tests (TOST) procedure was used to assess these markers in iNPH, PSP, and HC.

Results

For all the three measures, intra-rater and inter-rater ICC were excellent (range = 0.91–0.93).

In the comparison of iNPH and PSP with HC, differences for MRPI and MRPI 2.0 (p < 0.01 in all cases) and no equivalence (p = 1.00 in all cases) were found at TOST. iNPH and PSP MRPI showed no difference (p = 0.06) and no equivalence (p = 0.08). MRPI 2.0 was not equivalent (p = 0.06) and not different (p = 0.09) in the same two populations. PSP and HC IPA proved equivalent (p < 0.01) while iNPH IPA was different (p < 0.01) and not equivalent (p = 0.96 and 0.82) from both PSP and HC.

Conclusion

MRPI and MRPI 2.0 significantly overlap in iNPH and PSP, with risk of misdiagnosis, and for this reason may not be helpful in the differential diagnosis.

Available only for authorised users

Williams MA, Malm J (2016) Diagnosis and treatment of idiopathic normal pressure hydrocephalus. Contin Lifelong Learn Neurol 22:579–599. https://doi.org/10.1212/CON.0000000000000305CrossRef

Höglinger GU, Respondek G, Stamelou M, Kurz C, Josephs KA, Lang AE, Mollenhauer B, Müller U, Nilsson C, Whitwell JL, Arzberger T, Englund E, Gelpi E, Giese A, Irwin DJ, Meissner WG, Pantelyat A, Rajput A, van Swieten JC, Troakes C, Antonini A, Bhatia KP, Bordelon Y, Compta Y, Corvol JC, Colosimo C, Dickson DW, Dodel R, Ferguson L, Grossman M, Kassubek J, Krismer F, Levin J, Lorenzl S, Morris HR, Nestor P, Oertel WH, Poewe W, Rabinovici G, Rowe JB, Schellenberg GD, Seppi K, van Eimeren T, Wenning GK, Boxer AL, Golbe LI, Litvan I, for the Movement Disorder Society-endorsed PSP Study Group (2017) Clinical diagnosis of progressive supranuclear palsy: the movement disorder society criteria. Mov Disord 32:853–864. https://doi.org/10.1002/mds.26987CrossRefPubMedPubMedCentral

Skalický P, Mládek A, Vlasák A, de Lacy P, Beneš V, Bradáč O (2019) Normal pressure hydrocephalus—an overview of pathophysiological mechanisms and diagnostic procedures. Neurosurg Rev. https://doi.org/10.1007/s10143-019-01201-5

Quattrone A, Nicoletti G, Aguglia U (2008) MR imaging index for differentiation of progressive supranuclear palsy from Parkinson disease and the Parkinson variant of multiple purpose : methods : results : conclusion. Radiology 246:214–221CrossRefPubMed

Quattrone A, Morelli M, Nigro S, Quattrone A, Vescio B, Arabia G, Nicoletti G, Nisticò R, Salsone M, Novellino F, Barbagallo G, le Piane E, Pugliese P, Bosco D, Vaccaro MG, Chiriaco C, Sabatini U, Vescio V, Stanà C, Rocca F, Gullà D, Caracciolo M (2018) A new MR imaging index for differentiation of progressive supranuclear palsy-parkinsonism from Parkinson’s disease. Park Relat Disord 54:3–8. https://doi.org/10.1016/j.parkreldis.2018.07.016CrossRef

Tipton PW, Konno T, Broderick DF, Dickson DW, Wszolek ZK (2016) Cerebral peduncle angle: unreliable in differentiating progressive supranuclear palsy from other neurodegenerative diseases. Parkinsonism Relat Disord 32:31–35. https://doi.org/10.1016/j.parkreldis.2016.08.009CrossRefPubMedPubMedCentral

Eraslan C, Acarer A, Guneyli S, Akyuz E, Aydin E, Colakoglu Z, Kitis O, Calli MC (2019) MRI evaluation of progressive supranuclear palsy: differentiation from Parkinson’s disease and multiple system atrophy. Neurol Res 41:110–117. https://doi.org/10.1080/01616412.2018.1541115CrossRefPubMed

Miskin N, Patel H, Franceschi AM, Ades-Aron B, le A, Damadian BE, Stanton C, Serulle Y, Golomb J, Gonen O, Rusinek H, George AE, For the Alzheimer’s Disease Neuroimaging Initiative (2017) Diagnosis of normal-pressure hydrocephalus: use of traditional measures in the era of volumetric MR imaging. Radiology 285:197–205. https://doi.org/10.1148/radiol.2017161216CrossRefPubMed

Ohara M, Hattori T, Yokota T (2020) Progressive supranuclear palsy often develops idiopathic normal pressure hydrocephalus-like MRI features. Eur J Neurol ene.14322. https://doi.org/10.1111/ene.14322

10.

Relkin N, Marmarou A, Klinge P et al (2005) Diagnosing idiopathic normal-pressure hydrocephalus. Neurosurgery 57:S2-4–S2-16. https://doi.org/10.1227/01.NEU.0000168185.29659.C5CrossRef

11.

Marmarou A, Bergsneider M, Klinge P et al (2005) The value of supplemental prognostic tests for the preoperative assessment of idiopathic normal-pressure hydrocephalus. Neurosurgery 57:S2-17–S2-28. https://doi.org/10.1227/01.NEU.0000168184.01002.60CrossRef

12.

Mori E, Ishikawa M, Kato T et al (2012) Guidelines for management of idiopathic normal pressure hydrocephalus: second edition. Neurol Med Chir (Tokyo) 52:775–809. https://doi.org/10.2176/nmc.52.775CrossRef

13.

Wang DJ, Pandey SK, Lee DH, Sharma M (2019) The interpeduncular angle: a practical and objective marker for the detection and diagnosis of intracranial hypotension on brain MRI. Am J Neuroradiol 40:1299–1303. https://doi.org/10.3174/ajnr.a6120CrossRefPubMedPubMedCentral

14.

Lakens D (2017) Equivalence Tests. Soc Psychol Personal Sci 8:355–362. https://doi.org/10.1177/1948550617697177CrossRefPubMedPubMedCentral

15.

Lauzon C, Caffo B (2009) Easy multiplicity control in equivalence testing using two one-sided tests. Am Stat 63:147–154. https://doi.org/10.1198/tast.2009.0029CrossRefPubMedPubMedCentral

16.

Anderson-Cook CM, Borror CM (2016) The difference between “equivalent” and “not different”. Qual Eng 28:249–262. https://doi.org/10.1080/08982112.2015.1079918CrossRef

17.

Koo TK, Li MY (2016) A guideline of selecting and reporting Intraclass correlation coefficients for reliability research. J Chiropr Med 15:155–163. https://doi.org/10.1016/j.jcm.2016.02.012CrossRefPubMedPubMedCentral

18.

R Core Team (2014) R: a language and environment for statistical computing

19.

Jaraj D, Rabiei K, Marlow T, Jensen C, Skoog I, Wikkelso C (2014) Prevalence of idiopathic normal-pressure hydrocephalus. Neurology 82:1449–1454. https://doi.org/10.1212/WNL.0000000000000342CrossRefPubMedPubMedCentral

20.

Mirzayan MJ, Luetjens G, Borremans JJ, Regel JP, Krauss JK (2010) Extended long-term (> 5 years) outcome of cerebrospinal fluid shunting in idiopathic normal pressure hydrocephalus. Neurosurgery 67:295–301. https://doi.org/10.1227/01.NEU.0000371972.74630.ECCrossRefPubMed

21.

Giordan E, Palandri G, Lanzino G, Murad MH, Elder BD (2019) Outcomes and complications of different surgical treatments for idiopathic normal pressure hydrocephalus: a systematic review and meta-analysis. J Neurosurg 131:1024–1036. https://doi.org/10.3171/2018.5.JNS1875CrossRef

22.

Kahlon B (2002) Comparison between the lumbar infusion and CSF tap tests to predict outcome after shunt surgery in suspected normal pressure hydrocephalus. J Neurol Neurosurg Psychiatry 73:721–726. https://doi.org/10.1136/jnnp.73.6.721CrossRefPubMedPubMedCentral

23.

Magdalinou NK, Ling H, Smith JDS, Schott JM, Watkins LD, Lees AJ (2013) Normal pressure hydrocephalus or progressive supranuclear palsy? A clinicopathological case series. J Neurol 260:1009–1013. https://doi.org/10.1007/s00415-012-6745-6CrossRefPubMed

24.

Hashimoto M, Ishikawa M, Mori E, Kuwana N (2010) Diagnosis of idiopathic normal pressure hydrocephalus is supported by MRI-based scheme: a prospective cohort study. Cerebrospinal Fluid Res 7:18. https://doi.org/10.1186/1743-8454-7-18CrossRefPubMedPubMedCentral

25.

Kockum K, Virhammar J, Riklund K, Söderström L, Larsson EM, Laurell K (2019) Standardized image evaluation in patients with idiopathic normal pressure hydrocephalus: consistency and reproducibility. Neuroradiology 61:1397–1406. https://doi.org/10.1007/s00234-019-02273-2CrossRefPubMedPubMedCentral

26.

Stezin A, Lenka A, Jhunjhunwala K, Saini J, Pal PK (2017) Advanced structural neuroimaging in progressive supranuclear palsy: where do we stand? Parkinsonism Relat Disord 36:19–32. https://doi.org/10.1016/j.parkreldis.2016.12.023CrossRefPubMed

27.

Pyatigorskaya N, Yahia-Cherif L, Gaurav R, Ewenczyk C, Gallea C, Valabregue R, Gargouri F, Magnin B, Degos B, Roze E, Bardinet E, Poupon C, Arnulf I, Vidailhet M, Lehericy S (2020) Multimodal magnetic resonance imaging quantification of brain changes in progressive supranuclear palsy. Mov Disord 35:161–170. https://doi.org/10.1002/mds.27877CrossRefPubMed

28.

Zhang K, Liang Z, Wang C, Zhang X, Yu B, Liu X (2019) Diagnostic validity of magnetic resonance parkinsonism index in differentiating patients with progressive supranuclear palsy from patients with Parkinson’s disease. Parkinsonism Relat Disord 66:176–181. https://doi.org/10.1016/j.parkreldis.2019.08.007CrossRefPubMed

29.

Nicoletti G, Caligiuri ME, Cherubini A, Morelli M, Novellino F, Arabia G, Salsone M, Quattrone A (2017) A fully automated, atlas-based approach for superior cerebellar peduncle evaluation in progressive supranuclear palsy phenotypes. Am J Neuroradiol 38:523–530. https://doi.org/10.3174/ajnr.A5048CrossRefPubMedPubMedCentral

30.

Constantinides VC, Paraskevas GP, Velonakis G, Toulas P, Stefanis L, Kapaki E (2020) Midbrain morphology in idiopathic normal pressure hydrocephalus: a progressive supranuclear palsy mimic. Acta Neurol Scand 141:328–334. https://doi.org/10.1111/ane.13205CrossRefPubMed

31.

Karimi M, Perlmutter JS (2011) MRI measures predict progressive supranuclear palsy: clinically useful? Neurology 77:1028–1029. https://doi.org/10.1212/WNL.0b013e31822e14c7CrossRefPubMed

32.

Morelli M, Arabia G, Novellino F, Salsone M, Giofre L, Condino F, Messina D, Quattrone A (2011) MRI measurements predict PSP in unclassifiable parkinsonisms: a cohort study. Neurology 77:1042–1047. https://doi.org/10.1212/WNL.0b013e31822e55d0CrossRefPubMed

33.

Quattrone A, Morelli M, Williams DR, Vescio B, Arabia G, Nigro S, Nicoletti G, Salsone M, Novellino F, Nisticò R, Pucci F, Chiriaco C, Pugliese P, Bosco D, Caracciolo M (2016) MR parkinsonism index predicts vertical supranuclear gaze palsy in patients with PSP–parkinsonism. Neurology 87:1266–1273. https://doi.org/10.1212/WNL.0000000000003125CrossRefPubMedPubMedCentral

34.

Picillo M, Tepedino MF, Abate F, Erro R, Ponticorvo S, Tartaglione S, Volpe G, Frosini D, Cecchi P, Cosottini M, Ceravolo R, Esposito F, Pellecchia MT, Barone P, Manara R (2020) Midbrain MRI assessments in progressive supranuclear palsy subtypes. J Neurol Neurosurg Psychiatry 91:98–103. https://doi.org/10.1136/jnnp-2019-321354CrossRefPubMed

Title: Magnetic resonance parkinsonism indices and interpeduncular angle in idiopathic normal pressure hydrocephalus and progressive supranuclear palsy
Authors: Lorenzo Ugga
Renato Cuocolo
Sirio Cocozza
Giuseppe Pontillo
Andrea Elefante
Mario Quarantelli
Caterina Vicidomini
Maria Francesca De Pandis
Giovanna De Michele
Alessandra D’Amico
Oreste de Divitiis
Arturo Brunetti
Publication date: 01-12-2020
Publisher: Springer Berlin Heidelberg
Keywords: Hydrocephalus
Hydrocephalus
Hydrocephalus
Progressive Supranuclear Palsy
Published in: Neuroradiology / Issue 12/2020
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-020-02500-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Magnetic resonance parkinsonism indices and interpeduncular angle in idiopathic normal pressure hydrocephalus and progressive supranuclear palsy

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 12/2020

Correction to: Automatic identification of atypical clinical fMRI results

Complex vascular anatomy is a predictor of silent cerebral ischemia after carotid artery stenting

Rare neurovascular conflict between oculomotor nerve and posterior communicating artery

Multimodal validation of focal enhancement in intracranial aneurysms as a surrogate marker for aneurysm instability

Dual-energy CT for differentiating acute intracranial hemorrhage from contrast staining or calcification: a meta-analysis

Bilateral lesions of the basal ganglia and thalami (central grey matter)—pictorial review