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 language | English |
|---|---|
| Pages (from-to) | 2775-2781 |
| Number of pages | 7 |
| Journal | Internal Medicine |
| Volume | 50 |
| Issue number | 22 |
| DOIs | |
| Publication status | Published - 2011 |
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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 journal › Article
}
TY - JOUR
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
UR - http://www.scopus.com/inward/record.url?scp=81155138948&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=81155138948&partnerID=8YFLogxK
U2 - 10.2169/internalmedicine.50.5954
DO - 10.2169/internalmedicine.50.5954
M3 - Article
C2 - 22082889
AN - SCOPUS:81155138948
VL - 50
SP - 2775
EP - 2781
JO - Internal Medicine
JF - Internal Medicine
SN - 0918-2918
IS - 22
ER -