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  • 1
    Online Resource
    Online Resource
    Development and Validation of Automated Magnetic Resonance Parkinsonism Index 2.0 to Distinguish Progressive Supranuclear Palsy‐Parkinsonism From Parkinson's Disease
    Wiley ; 2022
    In:  Movement Disorders Vol. 37, No. 6 ( 2022-06), p. 1272-1281
    Details
    In: Movement Disorders, Wiley, Vol. 37, No. 6 ( 2022-06), p. 1272-1281
    Abstract: Differentiating progressive supranuclear palsy‐parkinsonism (PSP‐P) from Parkinson's disease (PD) is clinically challenging. Objective This study aimed to develop an automated Magnetic Resonance Parkinsonism Index 2.0 (MRPI 2.0) algorithm to distinguish PSP‐P from PD and to validate its diagnostic performance in two large independent cohorts. Methods We enrolled 676 participants: a training cohort (n = 346; 43 PSP‐P, 194 PD, and 109 control subjects) from our center and an independent testing cohort (n = 330; 62 PSP‐P, 171 PD, and 97 control subjects) from an international research group. We developed a new in‐house algorithm for MRPI 2.0 calculation and assessed its performance in distinguishing PSP‐P from PD and control subjects in both cohorts using receiver operating characteristic curves. Results The automated MRPI 2.0 showed excellent performance in differentiating patients with PSP‐P from patients with PD and control subjects both in the training cohort (area under the receiver operating characteristic curve [AUC] = 0.93 [95% confidence interval, 0.89–0.98] and AUC = 0.97 [0.93–1.00], respectively) and in the international testing cohort (PSP‐P versus PD, AUC = 0.92 [0.87–0.97] ; PSP‐P versus controls, AUC = 0.94 [0.90–0.98]), suggesting the generalizability of the results. The automated MRPI 2.0 also accurately distinguished between PSP‐P and PD in the early stage of the diseases (AUC = 0.91 [0.84–0.97] ). A strong correlation ( r  = 0.91, P   〈  0.001) was found between automated and manual MRPI 2.0 values. Conclusions Our study provides an automated, validated, and generalizable magnetic resonance biomarker to distinguish PSP‐P from PD. The use of the automated MRPI 2.0 algorithm rather than manual measurements could be important to standardize measures in patients with PSP‐P across centers, with a positive impact on multicenter studies and clinical trials involving patients from different geographic regions. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society
    Type of Medium: Online Resource
    ISSN: 0885-3185 , 1531-8257
    URL: Issue
    URL: Article
    DOI: 10.1002/mds.v37.6
    DOI: 10.1002/mds.28992
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2041249-6
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  • 2
    Online Resource
    Online Resource
    Automated MRI Classification in Progressive Supranuclear Palsy: A Large International Cohort Study
    Wiley ; 2020
    In:  Movement Disorders Vol. 35, No. 6 ( 2020-06), p. 976-983
    Details
    In: Movement Disorders, Wiley, Vol. 35, No. 6 ( 2020-06), p. 976-983
    Abstract: The Magnetic Resonance Parkinsonism Index is listed as one of the most reliable imaging morphometric markers for diagnosis of progressive supranuclear palsy (PSP). However, the use of this index in diagnostic workup has been limited until now by the low generalizability of published results because of small monocentric patient cohorts, the lack of data validation in independent patient series, and manual measurements used for index calculation. The objectives of this study were to investigate the generalizability of Magnetic Resonance Parkinsonism Index performance validating previously established cutoff values in a large international cohort of PSP patients subclassified into PSP–Richardson's syndrome and PSP‐parkinsonism and to standardize the use of the automated Magnetic Resonance Parkinsonism Index by providing a web‐based platform to obtain homogenous measures around the world. Methods In a retrospective international multicenter study, a total of 173 PSP patients and 483 non‐PSP participants were enrolled. A web‐based platform ( https://mrpi.unicz.it ) was used to calculate automated Magnetic Resonance Parkinsonism Index values. Results Magnetic Resonance Parkinsonism Index values showed optimal performance in differentiating PSP–Richardson's syndrome and PSP‐parkinsonism patients from non‐PSP participants (93.6% and 86.5% of accuracy, respectively). The Magnetic Resonance Parkinsonism Index was also able to differentiate PSP–Richardson's syndrome and PSP‐parkinsonism patients in an early stage of the disease from non‐PSP participants (90.1% and 85.9%, respectively). The web‐based platform provided the automated Magnetic Resonance Parkinsonism Index calculation in 94% of cases. Conclusions Our study provides the first evidence on the generalizability of automated Magnetic Resonance Parkinsonism Index measures in a large international cohort of PSP–Richardson's syndrome and PSP‐parkinsonism patients. The web‐based platform enables widespread applicability of the automated Magnetic Resonance Parkinsonism Index to different clinical and research settings. © 2020 International Parkinson and Movement Disorder Society
    Type of Medium: Online Resource
    ISSN: 0885-3185 , 1531-8257
    URL: Issue
    URL: Article
    DOI: 10.1002/mds.v35.6
    DOI: 10.1002/mds.28007
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2041249-6
    Location Call Number Limitation Availability
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    Online Resource
  • 3
    Online Resource
    Online Resource
    A New MRI Measure to Early Differentiate Progressive Supranuclear Palsy From De Novo Parkinson's Disease in Clinical Practice: An International Study
    Wiley ; 2021
    In:  Movement Disorders Vol. 36, No. 3 ( 2021-03), p. 681-689
    Details
    In: Movement Disorders, Wiley, Vol. 36, No. 3 ( 2021-03), p. 681-689
    Abstract: Enlargement of the third ventricle has been reported in atypical parkinsonism. We investigated whether the measurement of third ventricle width could distinguish Parkinson's disease (PD) from progressive supranuclear palsy (PSP). Methods We assessed a new MR T1‐weighted measurement (third ventricle width/internal skull diameter) in a training cohort of 268 participants (98 PD, 73 PSP, 98 controls from our center) and in a testing cohort of 291 participants (82 de novo PD patients and 133 controls from the Parkinson's Progression Markers Initiative, 76 early‐stage PSP from an international research group). PD diagnosis was confirmed after a 4‐year follow‐up. Diagnostic performance of the third ventricle/internal skull diameter was assessed using receiver operating characteristic curve with bootstrapping; the area under the curve of the training cohort was compared with the area under the curve of the testing cohort using the De Long test. Results In both cohorts, third ventricle/internal skull diameter values did not differ between PD and controls but were significantly lower in PD than in PSP patients ( P   〈  0.0001). In PD, third ventricle/internal skull diameter values did not change significantly between baseline and follow‐up evaluation. Receiver operating characteristic analysis accurately differentiated PD from PSP in the training cohort (area under the curve, 0.94; 95% CI, 91.1–97.6; cutoff, 5.72) and in the testing cohort (area under the curve, 0.91; 95% CI, 87.0–97.0; cutoff,: 5.88), validating the generalizability of the results. Conclusion Our study provides a new reliable and validated MRI measurement for the early differentiation of PD and PSP. The simplicity and generalizability of this biomarker make it suitable for routine clinical practice and for selection of patients in clinical trials worldwide. © 2020 International Parkinson and Movement Disorder Society
    Type of Medium: Online Resource
    ISSN: 0885-3185 , 1531-8257
    URL: Issue
    URL: Article
    DOI: 10.1002/mds.v36.3
    DOI: 10.1002/mds.28364
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2041249-6
    Location Call Number Limitation Availability
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