Accuracy of the national institute for neurological disorders and stroke/society for progressive supranuclear palsy and neuroprotection and natural history in Parkinson plus syndromes criteria for the diagnosis of progressive supranuclear palsy
Accuracy of the national institute for neurological disorders and stroke/society for progressive supranuclear palsy and neuroprotection and natural history in Parkinson plus syndromes criteria for the diagnosis of progressive supranuclear palsy
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DOI：
10.1002/mds.25327
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发表时间：
2013-04-01
影响因子：
8.6
通讯作者：
Hoeglinger, Guenter U.
中科院分区：
文献类型：
--
作者：
Respondek, Gesine;Roeber, Sigrun;Hoeglinger, Guenter U.
尸检是进行性核上性麻痹(PSP)的黄金诊断标准。美国国家神经疾病和卒中研究所和进行性核上性麻痹学会(NINDS-SPSP)临床诊断可能的PSP的标准被认为具有高特异性和低敏感性。NINDS-SPSP对可能的PSP的标准被认为是以牺牲特异性为代价来增加敏感性的。帕金森综合征的神经保护和自然病史(NNIPPS)标准旨在提高敏感性，同时保持高特异性。本研究的目的是对三级神经科中心的NINDS-SPSP和NNIPPS标准进行临床病理评估。通过图表回顾记录了来自四个欧洲脑库的神经病理诊断为PSP、帕金森氏病(PD)、MSA帕金森综合征和皮质基底部变性的患者的明确临床特征及其发病年份。在发病后的每一年和最终的生前记录中，对临床诊断标准的满足情况进行验证。我们对98例PSP患者和46例疾病对照进行了分析。与NNIPPS标准相比，NINDS-SPSP可能标准的诊断时间更短，特异度和阳性预测值(PPV)略高，敏感性相似。出乎意料的是，NINDS-SPSP可能的标准产生了最低的敏感性、特异性和PPV。NINDS-SPSP可能标准和可能标准的组合产生了最高的敏感性。我们建议NINDS-SPSP可能是招募患者参加临床试验的首选标准，因为在临床试验中，早期和特定的诊断是重要的。对于常规的临床护理，高敏感性是至关重要的，NINDS可能和可能的标准的组合可能是首选。(C)2013年运动无序社
Autopsy is the diagnostic gold standard for progressive supranuclear palsy (PSP). The National Institute of Neurological Disorders and Stroke and Society for Progressive Supranuclear Palsy (NINDS-SPSP) criteria for the clinical diagnosis of probable PSP are thought to possess high specificity and low sensitivity. The NINDS-SPSP criteria for possible PSP are considered to increase sensitivity at the expense of specificity. The Neuroprotection and Natural History in Parkinson Plus Syndromes (NNIPPS) criteria are intended to improve sensitivity while maintaining high specificity. The aim of this study was to conduct a clinicopathological evaluation of the NINDS-SPSP and NNIPPS criteria in tertiary neurological centers. Defined clinical features and their year of onset were recorded by chart review in neuropathologically diagnosed patients with PSP, Parkinsons's disease (PD), MSA parkinsonism and corticobasal degeneration from four European brain banks. Fulfilment of the clinical diagnostic criteria was verified for each year after disease onset and for the final antemortem record. We analyzed 98 PSP patients and 46 disease controls. The NINDS-SPSP probable criteria yielded shorter time to diagnosis, slightly higher specificity and positive predictive value (PPV), and similar sensitivity, compared with the NNIPPS criteria. Unexpectedly, the NINDS-SPSP possible criteria yielded the lowest sensitivity, specificity, and PPV. A combination of NINDS-SPSP possible and probable criteria yielded the highest sensitivity. We suggest that the NINDS-SPSP probable criteria might be preferred for recruitment of patients for clinical trials, where an early and specific diagnosis is important. For routine clinical care, where high sensitivity is crucial, a combination of NINDS possible and probable criteria might be preferred. (c) 2013 Movement Disorder Society