Planimetric and Volumetric Brainstem MRI Markers in Progressive Supranuclear Palsy, Multiple System Atrophy, and Corticobasal Syndrome. A Systematic Review and Meta-Analysis

• Main Authors: Maria-Evgenia Brinia (Author), Ioanna Kapsali (Author), Nikolaos Giagkou (Author), Vasilios C. Constantinides (Author)
• Format: Book
• Published: MDPI AG, 2023-12-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.3390/neurolint16010001; 2035-8377
• Keywords: Richardson's syndrome; progressive supranuclear palsy; multiple system atrophy; corticobasal syndrome; planimetry; volumetry; Medicine; R; Internal medicine; RC31-1245; Neurosciences. Biological psychiatry. Neuropsychiatry; RC321-571; Neurosciences. Biological psychiatry. Neuropsychiatry; RC321-571
• Source: Neurology International, Vol 16, Iss 1, Pp 1-19 (2023)

Background: Various MRI markers-including midbrain and pons areas (M_area, P_area) and volumes (M_vol, P_vol), ratios (M/P_area, M/P_vol), and composite markers (magnetic resonance imaging Parkinsonism Indices 1,2; MRPI 1,2)-have been proposed as imaging markers of Richardson's syndrome (RS) and multiple system atrophy-Parkinsonism (MSA-P). A systematic review/meta-analysis of relevant studies aiming to compare the diagnostic accuracy of these imaging markers is lacking. Methods: Pubmed and Scopus were searched for studies with >10 patients (RS, MSA-P or CBS) and >10 controls with data on M_area, P_area, M_vol, P_vol, M/P_area, M/P_vol, MRPI 1, and MRPI 2. Cohen's <i>d</i>, as a measure of effect size, was calculated for all markers in RS, MSA-P, and CBS. Results: Twenty-five studies on RS, five studies on MSA-P, and four studies on CBS were included. Midbrain area provided the greatest effect size for differentiating RS from controls (Cohen's <i>d</i> = −3.10; <i>p</i> < 0.001), followed by M/P_area and MRPI 1. MSA-P had decreased midbrain and pontine areas. Included studies exhibited high heterogeneity, whereas publication bias was low. Conclusions: Midbrain area is the optimal MRI marker for RS, and pons area is optimal for MSA-P. M/P_area and MRPIs produce smaller effect sizes for differentiating RS from controls.