Brain gray matter abnormalities in progressive supranuclear palsy revisited
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PingLei Pan1,2, Yi Liu1,3,4,5,6, Yang Zhang1,3,4,5,6, Hui Zhao1,3,4,5,6, Xing Ye1,3,4,5,6 and Yun Xu1,3,4,5,6
1Department of Neurology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, PR China
2Department of Neurology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, PR China
3The State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, PR China
4Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, PR China
5Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, PR China
6Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, PR China
Yun Xu, email: email@example.com
Keywords: progressive supranuclear palsy, voxel-based morphometry, meta-analysis, cortical-subcortical circuitries, seed-based d mapping
Received: February 21, 2017 Accepted: August 26, 2017 Published: September 15, 2017
Whole-brain voxel-based morphometry (VBM) studies of progressive supranuclear palsy (PSP) have demonstrated heterogeneous findings regarding gray matter (GM) abnormalities. Here, we used Seed-based d Mapping, a coordinate-based meta-analytic approach to identify consistent regions of GM anomalies across studies of PSP. Totally, 18 original VBM studies, comprising 284 patients with PSP and 367 healthy controls were included. As compared to healthy controls, patients with PSP demonstrated significant GM reductions in both cortical and subcortical regions, including the frontal motor cortices, medial (including anterior cingulate cortex) and lateral frontal cortices, insula, superior temporal gyrus, striatum (putamen and caudate nucleus), thalamus, midbrain, and anterior cerebellum. Our study further suggests that many confounding factors, such as age, male ratio, motor severity, cognitive impairment severity, and illness duration of PSP patients, and scanner field-strength, could contribute to the heterogeneity of GM alterations in PSP across studies. Our comprehensive meta-analysis demonstrates a specific neuroanatomical pattern of GM atrophy in PSP with the involvement of the cortical-subcortical circuitries that mediate vertical supranuclear gaze palsy, motor disabilities (postural instability with falls and parkinsonism), and cognitive-behavioral disturbances. Confounding factors merit attention in future studies.
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