Clinical value of MRI and acute madopar responsiveness test in diagnosing progressive supranuclear palsy

Abstract

Objective To investigate the MRI abnormalities and acute madopar responsiveness test in diagnosing progressive supranuclear palsy (PSP) and Parkinson's disease (PD). Methods Seventeen patients with PSP and 17 gender and age matched patients with PD were studied with cranial MRI examinations and results of acute madopar responsiveness test, and the clinical manifestations of PSP were summarized. Results The atrophy of the midbrain tegmentum and hummingbird sign was demonstrated in all of the PSP patients in our study, but was not observed in the PD patients. The areas of the midbrain on mid-sagittal MRI in PSP patients [(77.35 ± 15.30) mm2] were significantly smaller than that in those with PD [(142.35 ± 31.49) mm2]. The average ratio of the area of the midbrain to the area of pons in the patients with PSP [(14.31 ± 2.47)%] was significantly smaller than that in those with PD [(24.08 ± 4.73)%; P = 0.000, for all]. According to the result of acute madopar responsiveness test, the maximum Unified Parkinson's Disease Rating Scale (UPDRS) Ⅲ improvement rate of 2 patients with PSP and 16 patients with PD was more than 30％ (χ2 = 23.142, P = 0.000). Conclusion The assessment of the mid-sagittal MRI and acute madopar responsiveness test may be a useful method to differentiate PSP from PD.