Midbrain Atrophy in Vascular Parkinsonism.
Summary of "Midbrain Atrophy in Vascular Parkinsonism."
Background: Midbrain atrophy is a well-known feature of progressive supranuclear palsy (PSP). Some clinical features of vascular parkinsonism (VP) such as pseudobulbar phenomena, lower body predominance and early postural instability suggest that the brainstem could be associated with VP. The aim of this study was to determine whether midbrain atrophy was present in patients with VP. Methods: We measured the midbrain (Amd) and pons area (Apn) of 20 patients with VP, 15 patients with probable PSP and 30 patients with idiopathic Parkinson's disease (IPD). The Amd and Apn were measured on mid-sagittal T(1)-weighted MRI scans using a computerized image analysis system. Results: For the Amd, the patients with VP (99.86 mm(2)) and PSP (87.30 mm(2)) had significantly smaller areas than the patients with IPD (130.52 mm(2)). For the Apn, there was a significant difference only between the VP (407.23 mm(2)) and the IPD (445.05 mm(2)) patients. The Amd/Apn ratios of the patients with VP (0.245) and PSP (0.208) were significantly smaller than in the patients with IPD (0.292). Conclusions: Our study shows that brainstem atrophy often occurs in patients with VP and the midbrain is more vulnerable than the pons to atrophic changes.
Affiliation
Department of Neurology, Chonnam National University Medical School, Gwangju, Republic of Korea.
Journal Details
This article was published in the following journal.
Name: European neurology
ISSN: 1421-9913
Pages: 296-301
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21508644
- DOI: http://dx.doi.org/10.1159/000326907
Medical and Biotech [MESH] Definitions
Parkinson Disease, Secondary
Conditions which feature clinical manifestations resembling primary Parkinson disease that are caused by a known or suspected condition. Examples include parkinsonism caused by vascular injury, drugs, trauma, toxin exposure, neoplasms, infections and degenerative or hereditary conditions. Clinical features may include bradykinesia, rigidity, parkinsonian gait, and masked facies. In general, tremor is less prominent in secondary parkinsonism than in the primary form. (From Joynt, Clinical Neurology, 1998, Ch38, pp39-42)
Optic Atrophies, Hereditary
Hereditary conditions that feature progressive visual loss in association with optic atrophy. Relatively common forms include autosomal dominant optic atrophy (OPTIC ATROPHY, AUTOSOMAL DOMINANT) and Leber hereditary optic atrophy (OPTIC ATROPHY, HEREDITARY, LEBER).
Mesencephalon
The middle of the three primitive cerebral vesicles of the embryonic brain. Without further subdivision, midbrain develops into a short, constricted portion connecting the PONS and the DIENCEPHALON. Midbrain contains two major parts, the dorsal TECTUM MESENCEPHALI and the ventral TEGMENTUM MESENCEPHALI, housing components of auditory, visual, and other sensorimoter systems.
Tegmentum Mesencephali
The portion of midbrain situated under the dorsal TECTUM MESENCEPHALI. The two ventrolateral cylindrical masses or peduncles are large nerve fiber bundles providing a tract of passage between the forebrain with the hindbrain. Ventral midbrain also contains three colorful structures: the grey matter (PERIAQUEDUCTAL GRAY), the black substance (SUBSTANTIA NIGRA), and the RED NUCLEUS.
Gyrate Atrophy
Progressive, autosomal recessive, diffuse atrophy of the choroid, pigment epithelium, and sensory retina that begins in childhood.
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