No effect of age, gender and total intracranial volume on brainstem MR planimetric measurements
Stephanie Mangesius1,2,3, Anna Hussl4, Susanne Tagwercher4
1Department of Neuroradiology, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria. stephanie.mangesius@i-med.ac.at.
Objectives:
MR planimetry of brainstem structures can be helpful for the discrimination of Parkinsonian syndromes. It has been suggested that ageing might influence brainstem MR measurements assessed by MR planimetry, while effects of gender and total intracranial volume (TIV) have not been assessed so far. The aim of this study was to evaluate age, gender and TIV effects on brainstem MR planimetric measures.
Methods:
Brainstem MR planimetric measures of diameters (midbrain, pons, middle and superior cerebellar peduncle) and areas (pons and midbrain), the derived ratios, and the magnetic resonance Parkinsonism index (MRPI) were assessed on 1.5-T MR images in a large cohort of 97 healthy controls and analysed for the influence of age, gender and TIV with univariate and multivariate linear models.
Results:
Neither gender nor age effects on planimetric measurements were observed in the population relevant for the differential diagnosis of neurodegenerative Parkinsonism, aged 50 to 80 years, except for single area-derived measurements, with gender effects on pontine area (p = 0.013) and age effects on midbrain area (p = 0.037). Results were similar upon inclusion of the TIV in the analyses.
Conclusions:
There is no need to correct for age, gender or TIV when using brainstem-derived MR planimetric measurements in the differential diagnosis of neurodegenerative Parkinsonism.
Key Points:
• There were no gender effects on single or combined imaging measurements of the brainstem in the population aged 50 to 80 years, the age range relevant for the differential diagnosis of neurodegenerative Parkinsonism (except for pontine area). • There were no age effects on single or combined imaging measurements of the brainstem in the population aged 50 to 80 years, the age range relevant for the differential diagnosis of neurodegenerative Parkinsonism (except for midbrain area). • There is no need for age- or gender-specific cut-offs for the relevant age group.
Insights
Age and gender do not significantly affect brainstem measurements used to diagnose Parkinsonian syndromes. These findings indicate that adjustments for age, gender, or total intracranial volume are unnecessary for MR planimetry in this context.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- MR planimetry aids in differentiating Parkinsonian syndromes.
- Potential influences of aging, gender, and TIV on brainstem MR measurements require investigation.
Purpose of the Study:
- To evaluate the effects of age, gender, and TIV on brainstem MR planimetric measures.
- To determine if corrections are needed for these factors in clinical diagnosis.
Main Methods:
- Assessed brainstem diameters and areas using MR planimetry on 1.5-T MR images.
- Analyzed data from 97 healthy controls using univariate and multivariate linear models.
- Investigated influence of age, gender, and TIV on MR planimetric measures and MRPI.
Main Results:
- No significant gender or age effects on most brainstem measurements in the 50-80 year age range.
- Minor exceptions: gender effect on pontine area (p=0.013) and age effect on midbrain area (p=0.037).
- Inclusion of TIV did not alter these findings.
Conclusions:
- No need to correct for age, gender, or TIV in brainstem MR planimetry for Parkinsonian syndrome diagnosis.
- Age- and gender-specific cut-offs are not required for the relevant age group.
- MR planimetry provides reliable brainstem measurements for differential diagnosis.
