- •The purpose was to clarify difference between PSP and PD in the dynamic CSF flow.
- •CSF flow was calculated by 15 images in MRI that was taken through a cardiac cycle.
- •The width of the CSF velocity showed significant declines in PSP than PD patients.
- •MRI measurement showed a good discrimination on the area of the midbrain aqueduct.
The purpose of this study was to clarify the difference between PSP and PD from the viewpoint of dynamic cerebrospinal fluid (CSF) flow focusing on the midbrain aqueduct.
Thirty-three PD patients (mean age 69.2 ± 7.9) and 35 PSP patients (mean age 70.5 ± 6.6) were included in this study. CSF flow was calculated by 15 images in an equidistant magnetic resonance imaging (MRI) sequence that was taken throughout a cardiac cycle.
Absolute values of the velocity (time points of 2–6 and 12–15, *p < 0.05), and the width of the CSF velocity (Vheight) (PSP, 5.1 ± 2.3 cm/s; PD, 6.0 ± 1.6 cm/s, p < 0.05) effectively discriminated PSP from PD patients. On the other hand, conventional MRI measurements discriminated well the midbrain aqueduct area (Area) (PSP, 7.7 ± 2.6 mm2; PD, 5.4 ± 1.8 mm2, p < 0.01). Two cutoff value lines (Vheight: 4.75, Area: 5.77) of the ROC curve analysis established two areas for discriminating PSP from PD.
In the present dynamic CSF flow study, it was newly found that mean velocity of each time point and Vheight showed a more significant decline in PSP than in PD patients, providing a sensitive biomarker for differentiating them. The combination of Vheight and Area could further discriminate PSP from PD patients.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of the Neurological Sciences
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Progressive Supranuclear Palsy. A heterogeneous degeneration involving the brain stem, basal ganglia and cerebellum with vertical gaze and pseudobulbar palsy, nuchal dystonia and dementia.Arch. Neurol. 1964; 10: 333-359
- The ‘subcortical dementia’ of progressive supranuclear palsy.J. Neurol. Neurosurg. Psychiatry. 1974; 37: 121-130
- Why do patients with PSP fall? Evidence for abnormal otolith responses.Neurology. 2008; 70: 802-809
- The diagnosis of Parkinson's disease.Lancet Neurol. 2006; 5: 75-86
- Clinical research criteria for the diagnosis of progressive supranuclear palsy (Steele–Richardson–Olszewski syndrome): report of the NINDS–SPSP international workshop.Neurology. 1996; 47: 1-9
- Which clinical features differentiate progressive supranuclear palsy (Steele–Richardson–Olszewski syndrome) from related disorders? A clinicopathological study.Brain. 1997; 120: 65-74
- Measurement of the midbrain diameter on routine magnetic resonance imaging: a simple and accurate method of differentiating between Parkinson disease and progressive supranuclear palsy.Arch. Neurol. 2001; 58: 1076-1079
- Voxel based morphometry reveals a distinct pattern of frontal atrophy in progressive supranuclear palsy.J. Neurol. Neurosurg. Psychiatry. 2004; 75: 246-249
- Quantitative analysis of cerebrospinal fluid flow in patients with cervical spondylosis using cine phase-contrast magnetic resonance imaging.Neurosurgery. 1999; 44: 779-784
- Phase-contrast MR imaging of the cervical CSF and spinal cord: volumetric motion analysis in patients with Chiari I malformation.AJNR Am. J. Neuroradiol. 2000; 21: 151-158
- Quantitative assessment of surgical decompression of the cervical spine with cine phase contrast magnetic resonance imaging.Neurosurgery. 2002; 50 (discussion 6): 791-795
- Venous and cerebrospinal fluid flow in multiple sclerosis: a case-control study.Ann. Neurol. 2010; 68: 255-259
- CSF flow dynamics in motor neuron disease.Neurol. Res. 2012; 34: 512-517
- Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases.J. Neurol. Neurosurg. Psychiatry. 1992; 55: 181-184
- MR imaging of the superior profile of the midbrain: differential diagnosis between progressive supranuclear palsy and Parkinson disease.AJNR Am. J. Neuroradiol. 2004; 25: 927-932
- Brain magnetic resonance imaging techniques in the diagnosis of parkinsonian syndromes.Neuroimaging Clin. N. Am. 2010; 20: 29-55
- Significance of apparent diffusion coefficient measurement for the differential diagnosis of multiple system atrophy, progressive supranuclear palsy, and Parkinson's disease: evaluation by 3.0-T MR imaging.Neuroradiology. 2012; 54: 947-955
- Cerebrospinal fluid tau in dementia disorders: a large scale multicenter study by a Japanese study group.Neurobiol. Aging. 2002; 23: 363-370
- Levels of brain related proteins in cerebrospinal fluid: an aid in the differential diagnosis of parkinsonian disorders.Parkinsonism Relat. Disord. 2009; 15: 205-212
- Normal and hydrocephalic brain dynamics: the role of reduced cerebrospinal fluid reabsorption in ventricular enlargement.Ann. Biomed. Eng. 2009; 37: 1434-1447
Published online: July 21, 2015
Accepted: July 16, 2015
Received in revised form: June 25, 2015
Received: January 7, 2015
© 2015 Elsevier B.V. Published by Elsevier Inc. All rights reserved.