The predictive power of transcranial sonography in movement disorders: a longitudinal cohort study

  • Daniela Monaco
  • Daniela Berg
  • Astrid Thomas
  • Vincenzo Di Stefano
  • Filomena Barbone
  • Michela Vitale
  • Camilla Ferrante
  • Laura Bonanni
  • Marta Di Nicola
  • Tonia Garzarella
  • Luciano Paolo Marchionno
  • Giovanni Malferrari
  • Rocco Di Mascio
  • Marco Onofrj
  • Raffaella Franciotti
Original Article


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.


Transcranial 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.


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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  • Daniela Monaco
    • 1
  • Daniela Berg
    • 2
  • Astrid Thomas
    • 3
  • Vincenzo Di Stefano
    • 3
  • Filomena Barbone
    • 3
  • Michela Vitale
    • 3
  • Camilla Ferrante
    • 3
  • Laura Bonanni
    • 3
  • Marta Di Nicola
    • 4
  • Tonia Garzarella
    • 5
  • Luciano Paolo Marchionno
    • 6
  • Giovanni Malferrari
    • 7
  • Rocco Di Mascio
    • 8
  • Marco Onofrj
    • 3
  • Raffaella Franciotti
    • 3
  1. 1.Stroke Unit, Department of Urgency and EmergencyS. Spirito HospitalPescaraItaly
  2. 2.Department of NeurologyChristian-Albrechts-University of KielKielGermany
  3. 3.Department of Neuroscience, Imaging and Clinical Sciences“G. d’Annunzio” UniversityChietiItaly
  4. 4.Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences“G. d’Annunzio” UniversityChietiItaly
  5. 5.Division of Hygiene, Epidemiology and Public Health, Department of Medicine and Science of Aging“G. d’Annunzio” UniversityChietiItaly
  6. 6.Department of NeurologySS Annunziata HospitalChietiItaly
  7. 7.Stroke Unit, Neurology UnitIRCCS Reggio EmiliaItaly
  8. 8.INPSChietiItaly

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