What features improve the accuracy of the clinical diagnosis of progressive supranuclear palsy‐parkinsonism (PSP‐P)?
Identifieur interne : 001911 ( Main/Exploration ); précédent : 001910; suivant : 001912What features improve the accuracy of the clinical diagnosis of progressive supranuclear palsy‐parkinsonism (PSP‐P)?
Auteurs : David R. Williams [Australie, Royaume-Uni] ; Andrew Lees (neurologue) [Royaume-Uni]Source :
- Movement Disorders [ 0885-3185 ] ; 2010-02-15.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Accuracy, Adult, Aged, Aged, 80 and over, Chi-Square Distribution, Diagnosis, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Nervous system diseases, PSP‐P, Parkinson disease, Parkinson's disease, Parkinsonian Disorders (classification), Parkinsonian Disorders (complications), Parkinsonian Disorders (diagnosis), Parkinsonism, Retrospective Studies, Richardson's disease, Supranuclear Palsy, Progressive (complications), Supranuclear Palsy, Progressive (diagnosis), Supranuclear ophthalmoplegia, progressive supranuclear palsy.
- MESH :
- classification : Parkinsonian Disorders.
- complications : Parkinsonian Disorders, Supranuclear Palsy, Progressive.
- diagnosis : Parkinsonian Disorders, Supranuclear Palsy, Progressive.
- Adult, Aged, Aged, 80 and over, Chi-Square Distribution, Diagnosis, Differential, Female, Humans, Male, Middle Aged, Retrospective Studies.
Abstract
Progressive supranuclear palsy‐parkinsonism (PSP‐P) is a primary tauopathy characterised by neurofibrillary degeneration, which is frequently mistaken for Parkinson's disease (PD), multiple system atrophy (MSA), and vascular parkinsonism (VP) at presentation. The aim of this study was to identify particular clinical features (green flags) that may be helpful in differentiating PSP‐P from these other disorders. We identified 37 patients with PSP‐P from 726 patients archived at the Queen Square Brain Bank. Using a retrospective case notes review the clinical features were compared between the PSP‐P group and Lewy body associated parkinsonism (PD, n = 444 and dementia with Lewy bodies (DLB), n = 46), MSA (n = 90), and VP (n = 19), using the χ2‐test for proportions for a two‐by‐two contingency table. The sensitivity, specificity, and positive predictive values (PPV) and negative predictive values (NPV) were calculated for individual clinical features. A specificity of >0.85 or a PPV of >0.85 were considered reliable discriminators. No clinical features were predictive of PSP‐P, but late drug induced dyskinesias (specificity 0.92, PPV 0.99), late autonomic dysfunction (specificity 0.94, PPV 0.99) and any visual hallucinations (specificity 0.94, PPV 0.99) were better in distinguishing PD and PSP‐P than predicted using operational diagnostic criteria for PD. PSP‐P shares many clinical features with PD and DLB, MSA and VP, but visual hallucinations, drug induced dyskinesias and autonomic dysfunction are very uncommon and may be helpful exclusion criteria. © 2010 Movement Disorder Society
Url:
DOI: 10.1002/mds.22977
Affiliations:
- Australie, Royaume-Uni
- Angleterre, Grand Londres
- Londres
- National Hospital for Neurology and Neurosurgery
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Le document en format XML
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Williams</name><affiliation wicri:level="1"><country xml:lang="fr">Australie</country><wicri:regionArea>Van Cleef Roet Centre for Nervous Diseases, Monash University, Melbourne, Victoria</wicri:regionArea><wicri:noRegion>Victoria</wicri:noRegion></affiliation><affiliation wicri:level="3"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Reta Lila Weston Institute of Neurological Studies, UCL, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Lees, Andrew J" sort="Lees, Andrew J" uniqKey="Lees A" first="Andrew J" last="Lees">Andrew Lees (neurologue)</name><affiliation wicri:level="3"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Reta Lila Weston Institute of Neurological Studies, UCL, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName><orgName>National Hospital for Neurology and Neurosurgery</orgName></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2010-02-15">2010-02-15</date><biblScope unit="vol">25</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="357">357</biblScope><biblScope unit="page" to="362">362</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">961EA1FA45D184DFF29798CEA114F84C3D261398</idno><idno type="DOI">10.1002/mds.22977</idno><idno type="ArticleID">MDS22977</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Accuracy</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Chi-Square Distribution</term><term>Diagnosis</term><term>Diagnosis, Differential</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Nervous system diseases</term><term>PSP‐P</term><term>Parkinson disease</term><term>Parkinson's disease</term><term>Parkinsonian Disorders (classification)</term><term>Parkinsonian Disorders (complications)</term><term>Parkinsonian Disorders (diagnosis)</term><term>Parkinsonism</term><term>Retrospective Studies</term><term>Richardson's disease</term><term>Supranuclear Palsy, Progressive (complications)</term><term>Supranuclear Palsy, Progressive (diagnosis)</term><term>Supranuclear ophthalmoplegia</term><term>progressive supranuclear palsy</term></keywords><keywords scheme="MESH" qualifier="classification" xml:lang="en"><term>Parkinsonian Disorders</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinsonian Disorders</term><term>Supranuclear Palsy, Progressive</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Parkinsonian Disorders</term><term>Supranuclear Palsy, Progressive</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Chi-Square Distribution</term><term>Diagnosis, Differential</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Retrospective Studies</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Diagnostic</term><term>Maladie de Parkinson</term><term>Ophtalmoplégie supranucléaire</term><term>Parkinsonisme</term><term>Pathologie du système nerveux</term><term>Précision</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Progressive supranuclear palsy‐parkinsonism (PSP‐P) is a primary tauopathy characterised by neurofibrillary degeneration, which is frequently mistaken for Parkinson's disease (PD), multiple system atrophy (MSA), and vascular parkinsonism (VP) at presentation. The aim of this study was to identify particular clinical features (green flags) that may be helpful in differentiating PSP‐P from these other disorders. We identified 37 patients with PSP‐P from 726 patients archived at the Queen Square Brain Bank. Using a retrospective case notes review the clinical features were compared between the PSP‐P group and Lewy body associated parkinsonism (PD, n = 444 and dementia with Lewy bodies (DLB), n = 46), MSA (n = 90), and VP (n = 19), using the χ2‐test for proportions for a two‐by‐two contingency table. The sensitivity, specificity, and positive predictive values (PPV) and negative predictive values (NPV) were calculated for individual clinical features. A specificity of >0.85 or a PPV of >0.85 were considered reliable discriminators. No clinical features were predictive of PSP‐P, but late drug induced dyskinesias (specificity 0.92, PPV 0.99), late autonomic dysfunction (specificity 0.94, PPV 0.99) and any visual hallucinations (specificity 0.94, PPV 0.99) were better in distinguishing PD and PSP‐P than predicted using operational diagnostic criteria for PD. PSP‐P shares many clinical features with PD and DLB, MSA and VP, but visual hallucinations, drug induced dyskinesias and autonomic dysfunction are very uncommon and may be helpful exclusion criteria. © 2010 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>Australie</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement><orgName><li>National Hospital for Neurology and Neurosurgery</li></orgName></list><tree><country name="Australie"><noRegion><name sortKey="Williams, David R" sort="Williams, David R" uniqKey="Williams D" first="David R" last="Williams">David R. Williams</name></noRegion></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Williams, David R" sort="Williams, David R" uniqKey="Williams D" first="David R" last="Williams">David R. Williams</name></region><name sortKey="Lees, Andrew J" sort="Lees, Andrew J" uniqKey="Lees A" first="Andrew J" last="Lees">Andrew Lees (neurologue)</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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