PT - JOURNAL ARTICLE AU - Marina Picillo AU - Maria Francesca Tepedino AU - Filomena Abate AU - Roberto Erro AU - Sara Ponticorvo AU - Salvatore Tartaglione AU - Giampiero Volpe AU - Daniela Frosini AU - Paolo Cecchi AU - Mirco Cosottini AU - Roberto Ceravolo AU - Fabrizio Esposito AU - Maria Teresa Pellecchia AU - Paolo Barone AU - Renzo Manara TI - Midbrain MRI assessments in progressive supranuclear palsy subtypes AID - 10.1136/jnnp-2019-321354 DP - 2020 Jan 01 TA - Journal of Neurology, Neurosurgery & Psychiatry PG - 98--103 VI - 91 IP - 1 4099 - http://jnnp.bmj.com/content/91/1/98.short 4100 - http://jnnp.bmj.com/content/91/1/98.full SO - J Neurol Neurosurg Psychiatry2020 Jan 01; 91 AB - Objectives To explore the role of the available midbrain-based MRI morphometric assessments in (1) differentiating among progressive supranuclear palsy (PSP) subtypes (PSP Richardson’s syndrome (PSP-RS), PSP with predominant parkinsonism (PSP-P) and the other variant syndromes of PSP (vPSP)), and (2) supporting the diagnosis of PSP subtypes compared with Parkinson’s disease (PD) and healthy controls (HC).Methods Seventy-eight patients with PSP (38 PSP-RS, 21 PSP-P and 19 vPSP), 35 PD and 38 HC were included in the present analysis. Available midbrain-based MRI morphometric assessments were calculated for all participants.Results Current MRI midbrain-based assessments do not display an adequate sensitivity and specificity profile in differentiating PSP subtypes. On the other hand, we confirmed MR Parkinsonism Index (MRPI) and pons area to midbrain area ratio (P/M) have adequate diagnostic value to support PSP-RS clinical diagnosis compared with both PD and HC, but low sensitivity and specificity profile in differentiating PSP-P from PD as well as from HC. The same measures show acceptable sensitivity and specificity profile in supporting clinical diagnosis of vPSP versus HC but not versus PD. Similar findings were detected for the newer MRPI and P/M versions.Conclusions Further studies are warranted to identify neuroimaging biomarkers supporting the clinical phenotypic categorisation of patients with PSP. MRPI and P/M have diagnostic value in supporting the clinical diagnosis of PSP-RS.Classification of evidence This study provides class III evidence that available MRI midbrain-based assessments do not have diagnostic value in differentiating the Movement Disorder Society PSP subtypes.