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Transcranial midbrain sonography and depressive symptoms in patients with Parkinson’s disease

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Abstract

Transcranial sonography (TCS) appeared to be a promising marker associated with depression: hypo/anechogenicity of the brainstem raphe (BR) was found in 50–70 % of patients with unipolar depression, in 40–60 % of depressed patients with Parkinson’s disease (PD), but also in 8–28 % of healthy controls. Our study included 120 consecutive PD outpatients. Abnormal BR echogenicity was found in 51 (43 %), while normal findings were present in 67 PD patients (57 %). Patients with abnormal BR echogenicity had higher scores on the Montgomery–Asberg Depression Rating Scale (MADRS) items of apparent sadness (p = 0.03), reported sadness (p = 0.01), and pessimistic thoughts (p = 0.049), when compared to those with normal BR. In the second part of the study, previously suggested cut-off value at 14/15 on the MADRS was used to dichotomize patients into depressed (dPD) (46 patients; 39 %) and non-depressed PD patients (ndPD) (72 patients; 61 %). Abnormal TCS BR findings were obtained in 27 dPD (58.7 %) and in only 24 ndPD patients (33.3 %) (p = 0.007): the risk that PD patients with the TCS BR abnormality would display depressive symptoms was about 3.5 times higher when compared to PD patients with intact BR, controlling for the effect of motor difficulties (cross-odds ratio; OR = 3.48). Therefore, at least in a subgroup of dPD patients, TCS of the midbrain midline structure may potentially be a useful tool for depressive symptoms prediction.

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Acknowledgments

This work has been supported by the Ministry of Education, Science, and Technological Development, Republic of Serbia (Project No. 175090).

Conflicts of interest

IS, LjZ, MM and AP declare no conflict of interest. ES receives speaker’s honoraria from Novartis, Boehringer Ingelheim, Pfizer and Lundbeck. VSK receives honoraria from Novartis, Boehringer Ingelheim, Pfizer, Lundbeck, Glaxo-Smith-Kline, Swiss-Pharm and Eurolek and a grant form SANU.

Ethical standard

The research presented in this study was approved by the Ethical Committee of the School of Medicine, University of Belgrade (Serbia), and written informed consent was obtained from each patient prior to their inclusion in this study. The authors declare that they acted in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.

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Authors and Affiliations

  1. Institute of Neurology, Clinical Center of Serbia, Dr Subotica 6, 11000, Belgrade, Serbia

    Iva Stanković, Elka Stefanova, Milija Mijajlović, Aleksandra Pavlović & Vladimir S. Kostić

  2. School of Medicine, University of Belgrade, Belgrade, Serbia

    Elka Stefanova, Milija Mijajlović, Aleksandra Pavlović & Vladimir S. Kostić

  3. Faculty of Philology, University of Belgrade, Belgrade, Serbia

    Ljubomir Žiropadja

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  1. Iva Stanković
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  6. Vladimir S. Kostić
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Correspondence to Vladimir S. Kostić.

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Stanković, I., Stefanova, E., Žiropadja, L. et al. Transcranial midbrain sonography and depressive symptoms in patients with Parkinson’s disease. J Neurol 262, 689–695 (2015). https://doi.org/10.1007/s00415-014-7624-0

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  • DOI: https://doi.org/10.1007/s00415-014-7624-0

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