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Research ArticleAdult Brain
Open Access

Normative Data for Brainstem Structures, the Midbrain-to-Pons Ratio, and the Magnetic Resonance Parkinsonism Index

S.T. Ruiz, R.V. Bakklund, A.K. Håberg and E.M. Berntsen
American Journal of Neuroradiology May 2022, 43 (5) 707-714; DOI: https://doi.org/10.3174/ajnr.A7485
S.T. Ruiz
aFrom the Department of Circulation and Medical Imaging (S.T.R., R.V.B., E.M.B.), Faculty of Medicine and Health Sciences
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  • ORCID record for S.T. Ruiz
R.V. Bakklund
aFrom the Department of Circulation and Medical Imaging (S.T.R., R.V.B., E.M.B.), Faculty of Medicine and Health Sciences
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A.K. Håberg
bNeuromedicine and Movement Sciences (A.K.H.), Norwegian University of Science and Technology, Trondheim, Norway
cDepartment of Radiology and Nuclear Medicine (A.K.H., E.M.B.), St. Olavs University Hospital, Trondheim, Norway
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E.M. Berntsen
aFrom the Department of Circulation and Medical Imaging (S.T.R., R.V.B., E.M.B.), Faculty of Medicine and Health Sciences
cDepartment of Radiology and Nuclear Medicine (A.K.H., E.M.B.), St. Olavs University Hospital, Trondheim, Norway
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    FIGURE.

    T1WI showing the 1st, 5th, 50th, 95th, and 99th percentiles for the midbrain and pons area, MCP and SCP widths for men as a whole group, as well as the same structures for the one male patient with verified PSP. Measurements of these structures are shown for the 50th percentile, which are also presented in high resolution in the Online Supplemental Data. The 50th percentile equals the mean. The line A is drawn between the superior pontine notch and the inferior point of the quadrigeminal plate, while line B is parallel to line A starting at the inferior pontine notch.

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    Table 1:

    Descriptives for all subjects and for each sexa

    All Subjects(n = 996)Women(n = 527)Men(n = 469)P ValuebCohen D
    Age (yr)59.0 (SD, 4.2)(50.5–66.8)58.7 (SD, 4.3)(50.5–66.3)59.2 (SD, 4.2)(51.0–66.8)P = .103
    Heightc (cm)171.2 (SD, 8.7)(148.4–196.7)165.2 (SD, 5.8)(148.4–186.7)178.0 (SD, 6.1)(161.9–196.7)P < .0012.17
    Weightc (kg)79.3 (SD, 13.5)(47.2–127.0)72.6 (SD, 11.8)(47.2–119.6)86.8 (SD, 11.1)(59.8–127.0)P < .0011.24
    BMIc27.0 (SD, 3.7)(18.3–41.7)26.6 (SD, 4.1)(18.3–41.7)27.4 (SD, 3.1)(19.6–40.1)P < .0010.21
    Midbrain (mm2)136.7 (SD, 20.5)(76.0–222.4)136.7 (SD, 19.7)(81.9–211.9)136.7 (SD, 21.4)(76.0–211.9)P = .985
    Pons (mm2)542.2 (SD, 57.8)(386.5–812.5)518.2 (SD, 47.8)(386.5–695.7)569.1 (SD, 56.2)(416.5–812.5)P < .0010.98
    MCP (mm)9.4 (SD, 0.8)(5.3–13.0)9.1 (SD, 0.8)(5.3–11.5)9.7 (SD, 0.8)(6.8–13.0)P < .0010.76
    SCP (mm)3.8 (SD, 0.5)(2.5–5.5)3.7 (SD, 0.5)(2.6–5.2)3.9 (SD, 0.5)(2.5–5.5)P < .0010.44
    M/P ratio0.25 (SD, 0.04)(0.14–0.41)0.26 (SD, 0.04)(0.15–0.41)0.24 (SD, 0.03)(0.14–0.36)P < .0010.67
    MRPI10.0 (SD, 1.9)(5.5–18.1)9.5 (SD, 1.7)(5.5–15.6)10.6 (SD, 2.0)(6.1–18.1)P < .0010.59
    • ↵a Data are mean (SD) and range.

    • ↵b Women versus men.

    • ↵c Missing data for 2 women and 1 man.

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    Table 2:

    Sex-specific percentiles in the different age groups

    Women (n = 527)Men (n = 469)
    1st5th50th95th99th1st5th50th95th99th
    Midbrain area
     50–54 yr (n = 121/91)93111142178207104113141183222
     55–59 yr (n = 187/159)10111013717419695107140176195
     60–66 yr (n = 219/219)8810213016617888101130166184
    Pons area
     50–54 yr (n = 121/91)405431517591616417478565670703
     55–59 yr (n = 187/159)414456517608642458480567678785
     60-66 yr (n = 219/219)413436516610664443476565659689
    MCP width
     50–54 yr (n = 121/91)7.98.29.410.611.38.08.29.711.311.9
     55–59 yr (n = 187/159)7.78.19.210.410.87.58.69.811.212.2
     60–66 yr (n = 219/219)7.27.69.010.510.97.78.49.711.011.7
    SCP width
     50–54 yr (n = 121/91)2.63.13.74.55.12.53.23.94.75.5
     55–59 yr (n = 187/159)2.83.13.84.54.92.83.14.04.74.8
     60–66 yr (n = 219/219)2.72.93.74.54.92.93.24.04.85.2
    M/P ratio
     50–54 yr (n = 121/91)0.210.220.280.340.380.180.210.250.320.36
     55–59 yr (n = 187/159)0.200.210.270.320.370.160.180.250.300.32
     60–66 yr (n = 219/219)0.170.190.260.320.330.170.180.230.290.30
    MRPI
     50–54 yr (n = 121/91)6.26.79.012.513.66.17.69.413.616.5
     55–59 yr (n = 187/159)5.67.29.212.214.07.37.810.114.817.1
     60–66 yr (n = 219/219)6.77.19.513.215.36.88.010.614.517.1
    • Note:—n = X/Y: X women and Y men.

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American Journal of Neuroradiology: 43 (5)
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S.T. Ruiz, R.V. Bakklund, A.K. Håberg, E.M. Berntsen
Normative Data for Brainstem Structures, the Midbrain-to-Pons Ratio, and the Magnetic Resonance Parkinsonism Index
American Journal of Neuroradiology May 2022, 43 (5) 707-714; DOI: 10.3174/ajnr.A7485

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Normative Data for Brainstem Structures, the Midbrain-to-Pons Ratio, and the Magnetic Resonance Parkinsonism Index
S.T. Ruiz, R.V. Bakklund, A.K. Håberg, E.M. Berntsen
American Journal of Neuroradiology May 2022, 43 (5) 707-714; DOI: 10.3174/ajnr.A7485
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