Category: Parkinsonism, Atypical: PSP, CBD
Objective: Parkinson’s Disease – Postural Instability Gait Disorder (PD-PIGD) and Progressive Supranuclear Palsy – Parkinsonism Predominant (PSP-P) are entities affected by difficulties in differentiation in clinical practice. The aim of the work is to assess whether the comparison of regions of interest (ROI) of patients with clinical diagnosis of PSP-P and PD-PIGD is relevant in possible differentiation.
Background: PD and PSP-P, especially during the first years since disease onset are clinically difficult to differentiate. During the past years, various methods such as magnetic resonance parkinsonism index were introduced and enabled extended examination at the boundaries of PD and PSP.
Method: 4 patients with clinical diagnosis of PD and 3 patients with clinical diagnosis of PSP-P were examined using Single Photon Emission Computed Tomography (SPECT) using HMPAO as a radiotracer. Perfusion in the regions of interest was evaluated using Scenium Software. Disease duration varied from 1,5 to 6 years. Perfusion was assessed in 4 regions of interest – basal ganglia, cerebellum, frontal lobe and thalamus. The mean standard deviations were based on the comparison of the results of examined patients and healthy volunteers from the database.
Results: Average mean standard deviations differed most significantly within the frontal lobe (left frontal lobe (L/R) – 1,4/0,37 in PSP-P and -0,58/-0,88 in PD. Hypoperfusion was more pronounced in PD. On the other hand hypoperfusion was more stressed in PSP-P in the thalamus – -2,13/-2,27 (-1,85/-1,43 in PD). The differences in the thalamus were less significant than within the frontal lobe. Hypoperfusion in the basal ganglia and cerebellum were more stressed in PD, however differences were not significant.
Conclusion: Comparison of perfusion within the frontal lobe in PSP-P and PD shows differences, which after confirmation based on larger groups could be interpreted as differentiating the entities. The presented study requires further research.
To cite this abstract in AMA style:
P. Alster, D. Koziorowski, L. Królicki, A. Friedman. Is brain perfusion a differentiating factor between Parkinson’s Disease (PD) and Progressive Supranuclear Palsy – Parkinsonism Predominant (PSP-P)? [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/is-brain-perfusion-a-differentiating-factor-between-parkinsons-disease-pd-and-progressive-supranuclear-palsy-parkinsonism-predominant-psp-p/. Accessed June 15, 2025.« Back to MDS Virtual Congress 2020
MDS Abstracts - https://www.mdsabstracts.org/abstract/is-brain-perfusion-a-differentiating-factor-between-parkinsons-disease-pd-and-progressive-supranuclear-palsy-parkinsonism-predominant-psp-p/