Neuroimaging correlates of postural instability in Progressive Supranuclear Palsy

• Published in: Parkinsonism & related disorders Vol. 113; p. 105768
• Main Authors: Calomino, Camilla, Quattrone, Andrea, Sarica, Alessia, Bianco, Maria Giovanna, Aracri, Federica, De Maria, Marida, Buonocore, Jolanda, Vaccaro, Maria Grazia, Vescio, Basilio, Quattrone, Aldo
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.08.2023
• Subjects: Falls; LASSO regression analysis; Postural instability; Progressive Supranuclear Palsy; Voxel-based morphometry; Postural instability; Falls; LASSO regression analysis; Progressive Supranuclear Palsy; Voxel-based morphometry
• ISSN: 1353-8020; 1873-5126; 1873-5126
• DOI: 10.1016/j.parkreldis.2023.105768

We aimed to identify the brain structures associated with postural instability (PI) in Progressive Supranuclear Palsy (PSP). Forty-seven PSP patients and 45 control subjects were enrolled in this study. PI was assessed using the items 27 and 28 of the PSP rating scale (postural instability score, PIS). PSP patients were compared with controls using voxel-based morphometry (VBM). In PSP patients, LASSO regression model was used to investigate associations between VBM-based Region-Of-Interest grey matter (GM) volumes and different categories of the PSP rating scale. A whole-brain multi-regression analysis was also used to identify brain areas where GM volumes correlated with the PIS in PSP patients. VBM analysis showed widespread GM atrophy (fronto-temporal-parietal-occipital regions, limbic lobes, insula, cerebellum, and basal ganglia) in PSP patients compared with control subjects. In PSP patients, LASSO regression analysis showed associations of the right cerebellar lobules IV-V with ocular motor category score, and the left Rolandic area with bulbar category score, while the right inferior frontal gyrus (IFG) was negatively correlated with the PIS. The whole-brain multi-regression analysis identified the right IFG as the only area significantly associated with the PIS. In our study, two different approaches demonstrated that the IFG volume was associated with PIS in PSP patients, suggesting that this area may play a role in the pathophysiological mechanisms underlying PI. Our findings may have important implications for developing optimal Transcranial Magnetic Stimulation protocols targeting IFG in parkinsonism with postural disorders. •The inferior frontal gyrus (IFG) volume was associated with Postural Instability (PI).•Cerebellum lobules IV-V volumes were associated with ocular dysfunction in PSP.•The Rolandic area correlated with the “Bulbar” category score of PSP Rating Scale.•Whole-brain regression confirmed the correlation between IFG and PI score.