A novel diagnostic marker for progressive supranuclear palsy targeting atrophy of the subthalamic nucleus

Introduction: Despite great progress in radiological diagnostic tools for neurodegenerative disorders, their diagnostic accuracy has been unsatisfactory. One of the pathological hallmarks of progressive supranuclear palsy (PSP) is atrophy of the subthalamic nucleus, which has not attracted much attention for imaging analysis. Methods: The clinical data of patients with PSP, multiple system atrophy (MSA), Parkinson?s disease (PD), and corticobasal syndrome (CBS) who underwent brain magnetic resonance imaging at our department between June 2019 and March 2020 were retrospectively reviewed. The volumes of the subthalamic nucleus and of the whole cerebrum were then analyzed and compared among the disorders. Results: Fourteen PSP-Richardson syndrome (RS), 14 MSA, 14 PD, and 8 CBS patients were assessed. The mean volume of the bilateral subthalamic nuclei was smaller in PSP patients (0.148 ? 0.012 cm3) than in MSA (0.183 ? 0.026 cm3; p < 0.001), PD (0.209 ? 0.031 cm3; p < 0.001), and CBS (0.180 ? 0.056 cm3; p < 0.001) patients. The volume of the whole cerebrum was not significantly different among the disorders. Using an STN volume cutoff of 0.01925, the sensitivity and specificity for differential diagnosis between PSP and the other disorders were 0.846 and 0.972, respectively. Conclusion: Subthalamic nucleus volume may be a useful diagnostic marker for PSP; it may easily differentiate it from other neurodegenerative parkinsonian disorders.

Automated summary

After analyzing and comparing the volumes of the subthalamic nucleus and whole cerebrum in patients with PSP, MSA, PD, and CBS, it was found that the volume of the subthalamic nucleus may be a useful diagnostic marker for PSP to differentiate it from other neurodegenerative parkinsonian disorders.