Yan Rolland MD, Presenter: Nothing to Disclose

Marc Verin MD, Abstract Co-Author: Nothing to Disclose

Till Karsten Hauser, Abstract Co-Author: Nothing to Disclose

Neil P. Deasy MD, Abstract Co-Author: Nothing to Disclose

Chirstine Payan, Abstract Co-Author: Nothing to Disclose

Gilbert Bensimon MD, Abstract Co-Author: Nothing to Disclose

MRI signs of PSP and MSA remain poorly known at present mainly because of 1) the few number of controlled studies and 2)the use of heterogeneous and non standardized MRI acquisition procedures.Our objective is to investigate the accuracy of routine MRI for the positive and differential diagnosis of PSP and MSA in the context of a randomized, double-blind, placebo-controlled trial (RCT).

NNIPPS project investigates the neuroprotective efficacy and safety of riluzole in MSA and PSP within a large multicentre European (France, UK, Germany) RCT. At inclusion in NNIPPS, all patients undergo a standardized MRI acquisition of the brain. MRIs are subsequently rated according to a semi quantitative scale including 32 items. For a reliability validation of the scale, two independent reporting were performed by two reading centres in each country, both blinded for clinical status. Clinical/MRI correlation is studied through non-parametric methods. MRI and clinical diagnosis agreement is examined through positive predictive values for MSA and PSP.

764 patients are included. MRI scoring data are available for 632 patients included (298 PSP and 334 MSA). Reliability assessment between the two centers shows moderate to good agreement for most items (kappa values > 0.5) in each country. All MRIs display brain abnormalities. The positive predictive values of MRI diagnosis for clinical diagnosis are above 80% for both PSP and MSA. Univariate comparisons of MRI signs show significant differences between PSP and MSA. Significant correlation was found between: (i) the cerebellar symptoms and the MRI items scoring for the pons and the cerebellum ; (ii) the parkinsonian symptoms and the MRI items for the putamen ; (iii) the oculomotor symptoms and the MRI items for the mesencephalon.

Our results evidence for the first time a significant correlation between radiological signs and clinical symptoms in PSP and MSA, and confirm the usefulness of routine MRI examination for both the positive and the differential diagnosis of these pathologies.

Y.R.,M.V.,T.H.,N.P.D.,C.P.,G.B.: This project is co-authored by the NNIPPS Study Group

Rolland, Y, Verin, M, Hauser, T, Deasy, N, Payan, C, Bensimon, G, Neuroprotection and Natural History in Parkinson Plus Syndromes Study (NNIPPS) : Results at Inclusion of the Magnetic Resonance Imaging Study in Progressive Supranuclear Palsy (PSP) and Multiple System Atrophy (MSA).  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4417022.html