Session Information
Date: Tuesday, September 24, 2019
Session Title: Parkinsonisms and Parkinson-Plus
Session Time: 1:45pm-3:15pm
Location: Agora 3 West, Level 3
Objective: To compare the diagnostic sensitivity of hummingbird and morning glory signs with that of the midbrain area and the midbrain to pons area ratio.To compare the diagnostic sensitivity of hummingbird and morning glory signs with that of the midbrain area and the midbrain to pons area ratio.
Background: In recent years, signs and imaging criteria have been proposed to aid in the diagnosis of progressive supranuclear palsy (PSP), namely the hummingbird sign, the morning glory sign, the midbrain area and the midbrain to pons area ratio; the latter two, being quantitative and more laborious, are not always calculated and may result in a decrease in the diagnostic sensitivity of MRI in patients with PSP.
Method: Retrospective analysis of a group of patients diagnosed with PSP by a neurologist between January 2010 to December 2018; MRI analisys of the hummingbird signal, morning glory, calculation of the midbrain area and the midbrain to pons area ratio was performed by an experienced observer. Normative values based on the work of Stefano Zanigni et al., 2016.
Results: Twenty patients with a diagnosis of probable, possible or suggestive of PSP, with MRI available for analysis, were identified: 12 women, mean age of 74 years, mean age of onset of symptoms at 69 years; mean time of 3.6 years from the first symptom to MRI. The sign of morning glory was present in 2 patients, the hummingbird signal in 9 patients, midbrain area below 102.5 cm2 in 10 patients, and midbrain to pons area ratio below 0.21 in 11 patients.
Conclusion: Decreased midbrain area and midbrain to pons area ratio were more frequently found than hummingbird and morning glory signs; althought the limitations of the small sample, we suggest that they be included in the neuroradiological protocols of patients with suspected PSP.
References: Stefano Zanigni et al. Accuracy of MR markers for differentiating Progressive Supranuclear Palsy from Parkinson’s disease. Neuroimage Clinical, 2016 May 30;11:736-742.
To cite this abstract in AMA style:
L. Marques, V. Silva, J. Araújo, S. Varanda, G. Carneiro, M. Rodrigues. Sensitivity of magnetic resonance imaging findings in the diagnosis of progressive supranuclear palsy [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/sensitivity-of-magnetic-resonance-imaging-findings-in-the-diagnosis-of-progressive-supranuclear-palsy/. Accessed May 13, 2025.« Back to 2019 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/sensitivity-of-magnetic-resonance-imaging-findings-in-the-diagnosis-of-progressive-supranuclear-palsy/