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Subregional thalamic atrophy in Progressive Supranuclear Palsy: A machine learning study.

Camilla Calomino¹, Maria Giovanna Bianco², Chiara Camastra²

¹Azienda Ospedaliero Universitaria "Renato Dulbecco", Catanzaro, Italy; Neuroscience Research Center, Magna Graecia University of Catanzaro, Italy.

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|April 10, 2026

Summary

Subregional thalamic atrophy, particularly in specific nuclei, can accurately distinguish Progressive Supranuclear Palsy (PSP) from Parkinson's disease (PD). This finding highlights thalamic nuclei volumes as a potential diagnostic biomarker for PSP.

Keywords:

MRI Machine learning Parkinson’s disease Progressive Supranuclear Palsy Thalamic nuclei

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Area of Science:

Neuroimaging
Neurology
Machine Learning

Background:

Previous MRI studies show whole thalamus atrophy in Progressive Supranuclear Palsy (PSP).
These studies did not evaluate specific thalamic substructures.
This research investigates thalamic subregional atrophy in PSP for diagnostic potential.

Purpose of the Study:

To assess atrophy in thalamic substructures in PSP patients.
To determine if thalamic subregional atrophy can aid in differentiating PSP from Parkinson's disease (PD).
To validate the diagnostic potential of thalamic nuclei volumes.

Main Methods:

Utilized T1-weighted MRI scans from 398 subjects (164 PSP, 180 PD, 64 controls).
Employed automatic probabilistic segmentation of thalamic nuclei to analyze subregional atrophy.
Applied machine learning (XGBoost) to distinguish PSP from PD, validated on an independent cohort.

Main Results:

PSP patients exhibited significant atrophy in lateral, paraventricular, and pulvinar thalamic nuclei compared to controls.
No significant thalamic differences were found between PD patients and controls.
The machine learning model accurately differentiated PSP from PD (AUC: 0.96), outperforming whole thalamus volume analysis.

Conclusions:

Subregional thalamic atrophy is prominent in PSP, affecting specific nuclei.
Machine learning models using thalamic nuclei volumes effectively distinguish PSP from PD.
Thalamic subregional atrophy shows promise as a diagnostic biomarker for PSP.