Sensitivity and Specificity of Diagnostic Criteria for Progressive Supranuclear Palsy
Sensitivity and Specificity of Diagnostic Criteria for Progressive Supranuclear Palsy
复制标题
DOI：
10.1002/mds.27619
复制
发表时间：
2019-08-01
影响因子：
8.6
通讯作者：
Josephs, Keith A.
中科院分区：
文献类型：
--
作者：
Ali, Farwa;Martin, Peter R.;Josephs, Keith A.
2017年，国际帕金森与运动障碍学会（International Parkinson and Movement Disorder Society）对PSP的不同表型提出了新的临床诊断标准。在本研究中，我们比较了新标准与美国国家神经疾病研究所和进行性核上性麻痹学会不同时期标准的敏感性和特异性。方法从美国进行性核上性麻痹学会脑库中筛选临床帕金森病、临床和/或神经病理诊断为PSP的患者。所有患者均由位于佛罗里达州、亚利桑那州和明尼苏达州梅奥诊所3个地点之一的神经科医生进行神经病理学诊断和详细的临床检查。采用盲法回顾性提取临床症状和体征，用于确定患者是否符合任一诊断标准。患者以3年为限分为早期和晚期两组。结果共纳入129例患者，其中有PSP病理66例（51%）。其余的人患有其他神经退行性疾病。国际帕金森和运动障碍协会标准的总体敏感性为87.9%，而美国国家神经疾病研究所和进行性核上性麻痹协会标准的敏感性为45.5%，而国际帕金森和运动障碍协会可能的PSP标准的特异性为85.7%，而美国国家神经疾病研究所和进行性核上性麻痹协会标准的特异性为90.5%。个别患者注意到多种PSP表型的特征。结论国际帕金森与运动障碍学会的标准可识别进行性核上性麻痹的多种表型，因此比以往的标准具有更高的敏感性。(c) 2019年国际帕金森和运动障碍学会
Background In 2017, the International Parkinson and Movement Disorder Society put forward new clinical criteria for the diagnosis of PSP, recognizing diverse PSP phenotypes. In this study, we compared the sensitivity and specificity of the new criteria with the National Institutes of Neurological Disease and Society for Progressive Supranuclear Palsy criteria at different times. Methods Patients with clinical parkinsonism, clinical and/or neuropathological diagnosis of PSP, were identified from the Society for Progressive Supranuclear Palsy brain bank. All patients had neuropathologic diagnoses and detailed clinical examination performed by a neurologist at 1 of the 3 Mayo Clinic sites, in Florida, Arizona, and Minnesota. Clinical symptoms and signs were abstracted retrospectively in a blinded fashion and used to determine whether patients met either diagnostic criterion. Patients were divided into early and late disease stage groups using a 3-year cutoff. Results A total of 129 patients were included, of whom 66 had PSP pathology (51%). The remainder had other neurodegenerative diseases. The overall sensitivity of the International Parkinson and Movement Disorder Society criteria was 87.9%, compared with 45.5% for the National Institutes of Neurological Disease and Society for Progressive Supranuclear Palsy criteria, whereas the specificity of the International Parkinson and Movement Disorder Society probable PSP criteria was 85.7%, compared with 90.5% for the National Institutes of Neurological Disease and Society for Progressive Supranuclear Palsy. Individual patients were noted to have features of multiple PSP phenotypes. Conclusion The International Parkinson and Movement Disorder Society criteria recognize several phenotypes of progressive supranuclear palsy and hence have higher sensitivity than the previous criteria. (c) 2019 International Parkinson and Movement Disorder Society