Could midbrain volume on MRI be used to guide diagnosis of progressive supranuclear palsy?
Reviewed by Lauren Hepworth

The authors present a cohort study, of patients with a likely diagnosis of progressive supranuclear palsy (PSP) using a combination of prospective assessment and retrospective review. The cohort comprised of 14 patients; the data for six patients was obtained through retrospective review. All patients had the following assessments: ocular motility limitations, Bell’s reflex, optokinetic nystagmus, and blink rate. A T1 weighted MRI was acquired, along with the same sequencing on 15 age-matched controls. The authors report statistically significant differences between patients with PSP and controls in the volume of the following brain areas: midbrain, tegmentum, tectum and medulla. No significant difference was found in the volume of the pons. The severity of upgaze limitation and PSP severity score both correlated with midbrain atrophy. This study adds to the existing literature on the structure-function association in PSP. The neuroimaging used in this study is readily available and therefore these measurements could be repeated in clinical practice to guide diagnosis. It must be highlighted that the sample of size of this study was small. Further research using multiple centres and a larger sample size are required to establish the true size of the correlations.

Clinical correlation between vertical gaze palsy and midbrain volume in progressive supranuclear palsy.
Buch KA, Bouffard MA, Kardon RH, et al.
JOURNAL OF NEURO-OPHTHALMOLOGY
2022;42(2):246-50.