PSP as distinguished from CBD, MSA-P and PD by clinical and imaging differences at an early stage

Tomoko Kurata, Satsuki Kametaka, Yasuyuki Ohta, Nobutoshi Morimoto, Shoko Deguchi, Kentaro Deguchi, Yoshio Ikeda, Yoshiki Takao, Taisei Ohta, Yasuhiro Manabe, Shuhei Sato, Koji Abe

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objective Because it is often difficult to precisely diagnose and distinguish progressive supranuclear palsy (PSP) from corticobasal degeneration (CBD), multiple system atrophy-parkinsonism (MSA-P) and Parkinson's disease (PD) at the onset of the disease, we compared the patients and clarified the features of these diseases. Methods We compared 77 PSP, 26 CBD, 26 MSA-P and 166 PD patients from clinical and imaging points of view including cerebral blood flow (CBF) in the frontal eye field. Results The clinical characteristics of PSP were supranuclear gaze disturbance, optokinetic nystagmus (OKN) impairment and falls at the first visit. On head MRI, midbrain tegmentum atrophy was much more frequently detected in PSP than in all of the other groups. Heart-to-mediastinum average count ratio (H/M) in iodine-123 meta-iodobenzyl guanidine ( 123I-MIBG) myocardial scintigraphy was not decreased in PSP, CBD, MSA-P and PD-Yahr 1 (-1), but patients of PD-2, 3, 4 and 5 showed a significant decrease compared with the PSP group. The CBF in the left frontal eye field of PD-3 group and that in right frontal eye field of PD-3 and PD-4 groups were lower than that of PSP group, although other groups showed a tendency without a significant decrease compared with PSP group. Conclusion PSP is distinguishable from CBD, MSA-P and PD even at the early stage with extra-ocular movement (EOM) disturbance, falls, atrophy of the midbrain tegmentum, and H/M in 123I-MIBG myocardial scintigraphy, and the reduction of CBF in area 8 could serve as a supplemental diagnostic method for distinguishing PSP from PD-3 or PD-4.

Original languageEnglish
Pages (from-to)2775-2781
Number of pages7
JournalInternal Medicine
Volume50
Issue number22
DOIs
Publication statusPublished - 2011

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Progressive Supranuclear Palsy
Multiple System Atrophy
Parkinsonian Disorders
Parkinson Disease
Cerebrovascular Circulation
Frontal Lobe
Tegmentum Mesencephali
3-Iodobenzylguanidine
Myocardial Perfusion Imaging
Atrophy
Optokinetic Nystagmus
Guanidine
Mediastinum
Eye Movements
Iodine
Head

Keywords

  • Ethyl cysteinate dimmer-single photon emission-computed tomography
  • Frontal eye field
  • Multiple system atrophy
  • Parkinson's disease
  • Progressive supranuclear palsy

ASJC Scopus subject areas

  • Internal Medicine

Cite this

PSP as distinguished from CBD, MSA-P and PD by clinical and imaging differences at an early stage. / Kurata, Tomoko; Kametaka, Satsuki; Ohta, Yasuyuki; Morimoto, Nobutoshi; Deguchi, Shoko; Deguchi, Kentaro; Ikeda, Yoshio; Takao, Yoshiki; Ohta, Taisei; Manabe, Yasuhiro; Sato, Shuhei; Abe, Koji.

In: Internal Medicine, Vol. 50, No. 22, 2011, p. 2775-2781.

Research output: Contribution to journalArticle

Kurata, T, Kametaka, S, Ohta, Y, Morimoto, N, Deguchi, S, Deguchi, K, Ikeda, Y, Takao, Y, Ohta, T, Manabe, Y, Sato, S & Abe, K 2011, 'PSP as distinguished from CBD, MSA-P and PD by clinical and imaging differences at an early stage', Internal Medicine, vol. 50, no. 22, pp. 2775-2781. https://doi.org/10.2169/internalmedicine.50.5954
Kurata, Tomoko ; Kametaka, Satsuki ; Ohta, Yasuyuki ; Morimoto, Nobutoshi ; Deguchi, Shoko ; Deguchi, Kentaro ; Ikeda, Yoshio ; Takao, Yoshiki ; Ohta, Taisei ; Manabe, Yasuhiro ; Sato, Shuhei ; Abe, Koji. / PSP as distinguished from CBD, MSA-P and PD by clinical and imaging differences at an early stage. In: Internal Medicine. 2011 ; Vol. 50, No. 22. pp. 2775-2781.
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title = "PSP as distinguished from CBD, MSA-P and PD by clinical and imaging differences at an early stage",
abstract = "Objective Because it is often difficult to precisely diagnose and distinguish progressive supranuclear palsy (PSP) from corticobasal degeneration (CBD), multiple system atrophy-parkinsonism (MSA-P) and Parkinson's disease (PD) at the onset of the disease, we compared the patients and clarified the features of these diseases. Methods We compared 77 PSP, 26 CBD, 26 MSA-P and 166 PD patients from clinical and imaging points of view including cerebral blood flow (CBF) in the frontal eye field. Results The clinical characteristics of PSP were supranuclear gaze disturbance, optokinetic nystagmus (OKN) impairment and falls at the first visit. On head MRI, midbrain tegmentum atrophy was much more frequently detected in PSP than in all of the other groups. Heart-to-mediastinum average count ratio (H/M) in iodine-123 meta-iodobenzyl guanidine ( 123I-MIBG) myocardial scintigraphy was not decreased in PSP, CBD, MSA-P and PD-Yahr 1 (-1), but patients of PD-2, 3, 4 and 5 showed a significant decrease compared with the PSP group. The CBF in the left frontal eye field of PD-3 group and that in right frontal eye field of PD-3 and PD-4 groups were lower than that of PSP group, although other groups showed a tendency without a significant decrease compared with PSP group. Conclusion PSP is distinguishable from CBD, MSA-P and PD even at the early stage with extra-ocular movement (EOM) disturbance, falls, atrophy of the midbrain tegmentum, and H/M in 123I-MIBG myocardial scintigraphy, and the reduction of CBF in area 8 could serve as a supplemental diagnostic method for distinguishing PSP from PD-3 or PD-4.",
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author = "Tomoko Kurata and Satsuki Kametaka and Yasuyuki Ohta and Nobutoshi Morimoto and Shoko Deguchi and Kentaro Deguchi and Yoshio Ikeda and Yoshiki Takao and Taisei Ohta and Yasuhiro Manabe and Shuhei Sato and Koji Abe",
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T1 - PSP as distinguished from CBD, MSA-P and PD by clinical and imaging differences at an early stage

AU - Kurata, Tomoko

AU - Kametaka, Satsuki

AU - Ohta, Yasuyuki

AU - Morimoto, Nobutoshi

AU - Deguchi, Shoko

AU - Deguchi, Kentaro

AU - Ikeda, Yoshio

AU - Takao, Yoshiki

AU - Ohta, Taisei

AU - Manabe, Yasuhiro

AU - Sato, Shuhei

AU - Abe, Koji

PY - 2011

Y1 - 2011

N2 - Objective Because it is often difficult to precisely diagnose and distinguish progressive supranuclear palsy (PSP) from corticobasal degeneration (CBD), multiple system atrophy-parkinsonism (MSA-P) and Parkinson's disease (PD) at the onset of the disease, we compared the patients and clarified the features of these diseases. Methods We compared 77 PSP, 26 CBD, 26 MSA-P and 166 PD patients from clinical and imaging points of view including cerebral blood flow (CBF) in the frontal eye field. Results The clinical characteristics of PSP were supranuclear gaze disturbance, optokinetic nystagmus (OKN) impairment and falls at the first visit. On head MRI, midbrain tegmentum atrophy was much more frequently detected in PSP than in all of the other groups. Heart-to-mediastinum average count ratio (H/M) in iodine-123 meta-iodobenzyl guanidine ( 123I-MIBG) myocardial scintigraphy was not decreased in PSP, CBD, MSA-P and PD-Yahr 1 (-1), but patients of PD-2, 3, 4 and 5 showed a significant decrease compared with the PSP group. The CBF in the left frontal eye field of PD-3 group and that in right frontal eye field of PD-3 and PD-4 groups were lower than that of PSP group, although other groups showed a tendency without a significant decrease compared with PSP group. Conclusion PSP is distinguishable from CBD, MSA-P and PD even at the early stage with extra-ocular movement (EOM) disturbance, falls, atrophy of the midbrain tegmentum, and H/M in 123I-MIBG myocardial scintigraphy, and the reduction of CBF in area 8 could serve as a supplemental diagnostic method for distinguishing PSP from PD-3 or PD-4.

AB - Objective Because it is often difficult to precisely diagnose and distinguish progressive supranuclear palsy (PSP) from corticobasal degeneration (CBD), multiple system atrophy-parkinsonism (MSA-P) and Parkinson's disease (PD) at the onset of the disease, we compared the patients and clarified the features of these diseases. Methods We compared 77 PSP, 26 CBD, 26 MSA-P and 166 PD patients from clinical and imaging points of view including cerebral blood flow (CBF) in the frontal eye field. Results The clinical characteristics of PSP were supranuclear gaze disturbance, optokinetic nystagmus (OKN) impairment and falls at the first visit. On head MRI, midbrain tegmentum atrophy was much more frequently detected in PSP than in all of the other groups. Heart-to-mediastinum average count ratio (H/M) in iodine-123 meta-iodobenzyl guanidine ( 123I-MIBG) myocardial scintigraphy was not decreased in PSP, CBD, MSA-P and PD-Yahr 1 (-1), but patients of PD-2, 3, 4 and 5 showed a significant decrease compared with the PSP group. The CBF in the left frontal eye field of PD-3 group and that in right frontal eye field of PD-3 and PD-4 groups were lower than that of PSP group, although other groups showed a tendency without a significant decrease compared with PSP group. Conclusion PSP is distinguishable from CBD, MSA-P and PD even at the early stage with extra-ocular movement (EOM) disturbance, falls, atrophy of the midbrain tegmentum, and H/M in 123I-MIBG myocardial scintigraphy, and the reduction of CBF in area 8 could serve as a supplemental diagnostic method for distinguishing PSP from PD-3 or PD-4.

KW - Ethyl cysteinate dimmer-single photon emission-computed tomography

KW - Frontal eye field

KW - Multiple system atrophy

KW - Parkinson's disease

KW - Progressive supranuclear palsy

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