The predictive power of transcranial sonography in movement disorders: a longitudinal cohort study
- 81 Downloads
Transcranial sonography (TCS) is a noninvasive, easily performed, and commonly available neuroimaging technique useful for the study of brain parenchyma in movement disorders. This tool has been increasingly used in the diagnosis of Parkinson’s disease and atypical parkinsonism. The aim of the study was to evaluate the applicability of this technique as supportive tool in the early diagnosis of movement disorders. We performed TCS on 315 individuals which were diagnosed as healthy controls or affected by idiopathic Parkinson’s disease, monogenetic subtypes of Parkinson’s disease, atypical parkinsonism, and Dementia with Lewy bodies. Five TCS diagnostic patterns were defined on the basis of substantia nigra’s and lenticular nuclei’s echogenicity. TCS evaluations were performed by two blinded neuro-sonographers. Clinical diagnosis on all individuals was performed at baseline and at 4-year follow-up. The concordance rate between TCS patterns and clinical diagnosis and the specificity of TCS pattern to discriminate each group of individuals were compared at baseline and at follow-up. The concordance rate between TCS patterns and clinical diagnosis of all individuals was 84% at baseline and increased at follow-up (91%) significantly (p = 0.01). The specificity of TCS pattern in the comparison between patients diagnosed as affected by idiopathic Parkinson’s disease and atypical parkinsonism showed a significant increase at follow-up (p = 0.03). Our study strongly confirms the role of TCS as a noninvasive and cost-effective tool in early diagnosis of movement disorders.
KeywordsTranscranial sonography Substantia nigra Lenticular nuclei Idiopathic Parkinson’s disease Atypical parkinsonism Dementia with Lewy bodies
Compliance with ethical standards
Statement of informed consent
The study was approved by the ethics committee. Written informed consent was obtained from each participant before the inclusion in the study.
- 8.Iranzo A, Lomeña F, Stockner H, Valldeoriola F, Vilaseca I, Salamero M, Molinuevo JL, Serradell M, Duch J, Pavía J, Gallego J, Seppi K, Högl B, Tolosa E, Poewe W, Santamaria J (2010) Sleep Innsbruck Barcelona (SINBAR) pattern. Decreased striatal dopamine transporter uptake and substantia nigra hyperechogenicity as risk markers of synucleinopathy in patients with idiopathic rapid-eye-movement sleep behavior disorder: a prospective study. Lancet Neurol 9(11):1070–1077CrossRefGoogle Scholar
- 9.Berg D, Seppi K, Behnke S, Liepelt I, Schweitzer K, Stockner H, Wollenweber F, Gaenslen A, Mahlknecht P, Spiegel J, Godau J, Huber H, Srulijes K, Kiechl S, Bentele M, Gasperi A, Schubert T, Hiry T, Probst M, Schneider V, Klenk J, Sawires M, Willeit J, Maetzler W, Fassbender K, Gasser T, Poewe W (2011) Enlarged substantia nigra hyperechogenicity and risk for Parkinson disease: a 37-month 3-center study of 1847 older persons. Arch Neurol 68(7):932–937CrossRefGoogle Scholar
- 13.Litvan I, Agid Y, Calne D, Campbell G, Dubois B, Duvoisin RC, Goetz CG, Golbe LI, Grafman J, Growdon JH, Hallett M, Jankovic J, Quinn NP, Tolosa E, Zee DS (1996) Clinical research criteria for the diagnosis of progressive supranuclear palsy (Steele-Richardson-Olszewski syndrome): report of the NINDS-SPSP international workshop. Neurology 47(1):1–9CrossRefGoogle Scholar
- 14.Gilman S, Wenning GK, Low PA, Brooks DJ, Mathias CJ, Trojanowski JQ, Wood NW, Colosimo C, Durr A, Fowler CJ, Kaufmann H, Klockgether T, Lees A, Poewe W, Quinn N, Revesz T, Robertson D, Sandroni P, Seppi K, Vidailhet M (2008) Second consensus statement on the diagnosis of multiple system atrophy. Neurology 71(9):670–676CrossRefGoogle Scholar
- 21.Gaenslen A, Unmuth B, Godau J, Liepelt I, Di Santo A, Johanna Schweitzer K, Gasser T, Machulla HJ, Reimold M, Marek K, Berg D (2008) The specificity and sensitivity of transcranial ultrasound in the differential diagnosis of Parkinson’s disease: a prospective blinded study. Lancet Neurol 7:417–424CrossRefGoogle Scholar
- 24.Berardelli A, Wenning GK, Antonini A, Berg D, Bloem BR, Bonifati V, Brooks D, Burn DJ, Colosimo C, Fanciulli A, Ferreira J, Gasser T, Grandas F, Kanovsky P, Kostic V, Kulisevsky J, Oertel W, Poewe W, Reese JP, Relja M, Ruzicka E, Schrag A, Seppi K, Taba P, Vidailhet M (2013) EFNS/MDS-ES/ENS [corrected] recommendations for the diagnosis of Parkinson’s disease. New European guidelines for the diagnosis of Parkinson’s disease. TCS evaluation has a level a of evidence in early and differential diagnosis of PD. Eur J Neurol 20:16–34CrossRefGoogle Scholar
- 30.Berg D, Behnke S, Seppi K, Godau J, Lerche S, Mahlknecht P, Liepelt-Scarfone I, Pausch C, Schneider N, Gaenslen A, Brockmann K, Srulijes K, Huber H, Wurster I, Stockner H, Kiechl S, Willeit J, Gasperi A, Fassbender K, Gasser T, Poewe W (2013) Enlarged hyperechogenic substantia nigra as a risk marker for Parkinson’s disease. Mov Disord 28(2):216–219CrossRefGoogle Scholar