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Substantia nigra hyperechogenicity in depressive subjects relates to motor asymmetry and impaired word fluency

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Abstract

Background

Substantia nigra hyperechogenicity (SNH) is a characteristic transcranial sonography (TCS) finding in Parkinson’s disease (PD). SNH, found also in about 10% of healthy adults, was related to a subclinical malfunction of the nigrostriatal dopaminergic system on positron emission tomography studies. Both, liability for developing PD and frequency of SNH were found to be increased in depressed subjects. Here, we investigated whether SNH in depression is related to motor or cognitive abnormalities resembling early PD.

Methods

Fourty-one patients with major depressive disorder and 15 with adjustment disorder with depressed mood were studied clinically and with TCS.

Results

Frequency of SNH was similar in both groups (39, 33%; Chi-square test, P = 0.70). Larger SN echogenic size correlated with larger right-to-left asymmetry of finger tapping (Spearman test, r = 0.37, P = 0.009) and lower verbal fluency (r = −0.35, P = 0.038). These correlations were stronger in patients at ages ≥ 50 years (r = 0.52, P = 0.007; r = −0.50, P = 0.020), and, independently from age, in patients with reduced echogenicity of brainstem raphe suggested to reflect alteration of the serotonergic system (r = 0.40, P = 0.045; r = −0.51, P = 0.044). Whereas bilateral sum score of finger tapping was negatively correlated with severity of depression on the beck depression inventory (r = −0.50, P = 0.001) and the Hamilton depression rating scale (r = −0.34, P = 0.019), no correlation was found between depression severity and tapping asymmetry, or between depression severity and verbal fluency.

Conclusion

Data suggest that TCS detects a subgroup of patients with depression characterized by symptoms of early parkinsonism who are possibly at an elevated risk of later developing definite PD.

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References

  1. Alex KD, Yavanian GJ, McFarlane HG, Pluto CP, Pehek EA (2005) Modulation of dopamine release by striatal 5-HT2C receptors. Synapse 55:242–251

    Article  PubMed  CAS  Google Scholar 

  2. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders. American Psychiatric Press, Washington DC

    Google Scholar 

  3. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561–571

    PubMed  CAS  Google Scholar 

  4. Becker G, Seufert J, Bogdahn U, Reichmann H, Reiners K (1995) Degeneration of substantia nigra in chronic Parkinson’s disease visualized by transcranial color-coded real-time sonography. Neurology 45:182–184

    PubMed  CAS  Google Scholar 

  5. Becker G, Becker T, Struck M, Lindner A, Burzer K, Retz W, Bogdahn U, Beckmann H (1995) Reduced echogenicity of brainstem raphe specific to unipolar depression: a transcranial color-coded real-time sonography study. Biol Psychiatry 38:180–184

    Article  PubMed  CAS  Google Scholar 

  6. Becker G, Berg D, Lesch KP, Becker T (2001) Basal limbic system alteration in major depression: a hypothesis supported by transcranial sonography and MRI findings. Int J Neuropsychopharmacol 4:21–31

    Article  PubMed  CAS  Google Scholar 

  7. Berg D, Becker G, Zeiler B, Tucha O, Hofmann E, Preier M, Benz P, Jost W, Reiners K, Lange KW (1999) Vulnerability of the nigrostriatal system as detected by transcranial ultrasound. Neurology 53:1026–1031

    PubMed  CAS  Google Scholar 

  8. Berg D, Jabs B, Merschdorf U, Beckmann H, Becker G (2001) Echogenicity of substantia nigra determined by transcranial ultrasound correlates with severity of parkinsonian symptoms induced by neuroleptic therapy. Biol Psychiatry 50:463–467

    Article  PubMed  CAS  Google Scholar 

  9. Berg D, Siefker C, Ruprecht-Dörfler P, Becker G (2001) Relationship of substantia nigra echogenicity and motor function in elderly subjects. Neurology 56:13–17

    Article  PubMed  CAS  Google Scholar 

  10. Berg D, Roggendorf W, Schröder U, Klein R, Tatschner T, Benz P, Tucha O, Preier M, Lange KW, Reiners K, Gerlach M, Becker G (2002) Echogenicity of the substantia nigra: association with increased iron content and marker for susceptibility to nigrostriatal injury. Arch Neurol 56:999–1005

    Article  Google Scholar 

  11. Berg D, Merz B, Reiners K, Naumann M, Becker G (2005) Five-year follow-up study of hyperechogenicity of the substantia nigra in Parkinson’s disease. Mov Disord 20:383–385

    Article  PubMed  Google Scholar 

  12. Brandt-Christensen M, Kvist K, Nilsson FM, Andersen PK, Kessing LV (2006) Treatment with antidepressants and lithium is associated with increased risk of treatment with antiparkinson drugs: a pharmacoepidemiological study. J Neurol Neurosurg Psychiatry 77:781–783

    Article  PubMed  CAS  Google Scholar 

  13. Brooks DJ, Doder M (2001) Depression in Parkinson’s disease. Curr Opin Neurol 14:465–470

    Article  PubMed  CAS  Google Scholar 

  14. Camicioli R, Grossmann SJ, Spencer PS, Hudnell K, Anger WK (2001) Discriminating mild parkinsonism: methods for epidemiological research. Mov Disord 16:33–40

    Article  PubMed  CAS  Google Scholar 

  15. Dujardin K, Duhamel A, Becquet E, Grunberg C, Defebvre L, Destee A (1999) Neuropsychological abnormalities in first degree relatives of patients with familial Parkinson’s disease. J Neurol Neurosurg Psychiatry 67:323–328

    Article  PubMed  CAS  Google Scholar 

  16. Fahn S, Elton RL, Members of the UPDRS Development Committee (1987) Unified Parkinson’s disease rating scale. In: Fahn S, Marsden CD, Goldstein M, Calne DB (eds) Recent developments in Parkinsońs disease II. Macmillan, New York, pp 153–163

  17. First MB, Spitzer RL, Gibbon M, Williams JBW (1996) Structured clinical interview for DSM-IV axis I disorders, clinician version (SCID-CV). American Psychiatric Press, Washington DC

    Google Scholar 

  18. Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198

    Article  PubMed  CAS  Google Scholar 

  19. Hamilton M (1967) Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol 6:278–296

    PubMed  CAS  Google Scholar 

  20. Jahanshahi M, Ardouin CM, Brown RG, Rothwell JC, Obeso J, Albanese A, Rodriguez-Oroz MC, Moro E, Benabid AL, Pollak P, Limousin-Dowsey P (2000) The impact of deep brain stimulation on executive function in Parkinson’s disease. Brain 123:1142–1154

    Article  PubMed  Google Scholar 

  21. Leentjens AF, Van den Akker M, Metsemakers JF, Lousberg R, Verhey FR (2003) Higher incidence of depression preceding the onset of Parkinson’s disease: a register study. Mov Disord 18:414–418

    Article  PubMed  Google Scholar 

  22. Lees AJ, Smith E (1983) Cognitive deficits in the early stages of Parkinson’s disease. Brain 106:257–270

    Article  PubMed  Google Scholar 

  23. Lees AJ (1992) When did Ray Kennedy’s Parkinson’s disease begin? Mov Disord 7:110–116

    Article  PubMed  CAS  Google Scholar 

  24. Lemke MR, Koethe NH, Schleidt M (2000) Segmentation of behavior and time structure of movements in depressed patients. Psychopathology 33:131–136

    Article  PubMed  CAS  Google Scholar 

  25. Lezak MD (1995) Neuropsychological assessment. Oxford University Press, New York

    Google Scholar 

  26. Nilsson FM, Kessing LV, Bolwig TG (2001) Increased risk of developing Parkinson’s disease for patients with major affective disorder: a register study. Acta Psychiatr Scand 104:380–386

    Article  PubMed  CAS  Google Scholar 

  27. Reitan RM (1985) Validity of the trail making test as an indication of organic brain damage. Percept Mot Skills 8:271–276

    Article  Google Scholar 

  28. Oldfield RC (1971) The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia 9:97–113

    Article  PubMed  CAS  Google Scholar 

  29. Ruprecht-Dorfler P, Klotz P, Becker G, Berg D (2007) Substantia nigra hyperechogenicity correlates with subtle motor dysfunction in tap dancers. Parkinsonism Relat Disord 13:362–364

    Article  PubMed  Google Scholar 

  30. Schuurman AG, van den Akker M, Ensinck KT, Metsemakers JF, Knottnerus JA, Leentjens AF, Buntinx F (2002) Increased risk of Parkinson’s disease after depression: a retrospective cohort study. Neurology 58:1501–1504

    PubMed  CAS  Google Scholar 

  31. Shiba M, Bower JH, Maraganore DM, McDonnell SK, Peterson BJ, Ahlskog JE, Schaid DJ, Rocca WA (2000) Anxiety disorders and depressive disorders preceding Parkinson’s disease: a case-control study. Mov Disord 15:669–677

    Article  PubMed  CAS  Google Scholar 

  32. Sobin C, Mayer L, Endicott J (1998) The motor agitation and retardation scale: a scale for the assessment of motor abnormalities in depressed patients. J Neuropsychiatry Clin Neurosci 10:85–92

    PubMed  CAS  Google Scholar 

  33. Sommer U, Hummel T, Cormann K, Mueller A, Frasnelli J, Kropp J, Reichmann H (2004) Detection of presymptomatic Parkinson’s disease: combining smell tests, transcranial sonography, and SPECT. Mov Disord 19:1196–1202

    Article  PubMed  Google Scholar 

  34. Uc EY, Rizzo M, Anderson SW, Qian S, Rodnitzky RL, Dawson JD (2005) Visual dysfunction in Parkinson disease without dementia. Neurology 65:1907–1913

    Article  PubMed  CAS  Google Scholar 

  35. Van Gerpen JA (2002) Drug-induced parkinsonism. Neurologist 8:363–370

    Article  PubMed  Google Scholar 

  36. Walter U, Niehaus L, Probst T, Benecke R, Meyer BU, Dressler D (2003) Brain parenchyma sonography discriminates Parkinson’s disease and atypical parkinsonian syndromes. Neurology 60:74–77

    Article  PubMed  CAS  Google Scholar 

  37. Walter U, Klein C, Hilker R, Benecke R, Pramstaller PP, Dressler D (2004) Brain parenchyma sonography detects preclinical parkinsonism. Mov Disord 19:1445–1449

    Article  PubMed  Google Scholar 

  38. Walter U, Dressler D, Wolters A, Wittstock M, Benecke R (2007) Transcranial brain sonography findings in clinical subgroups of idiopathic Parkinson’s disease. Mov Disord 22:48–54

    Article  PubMed  Google Scholar 

  39. Walter U, Hoeppner J, Prudente-Morrissey L, Horowski S, Herpertz SC, Benecke R (2007) Parkinson’s disease-like midbrain sonography abnormalities are frequent in depressive disorders. Brain 130:1799–1807

    Article  PubMed  Google Scholar 

  40. Walter U, Prudente-Morrissey L, Herpertz SC, Benecke R, Hoeppner J (2007) Relationship of brainstem raphe echogenicity and clinical findings in depressive states. Psychiatry Res 155:67–73

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Dept. of Psychiatry and Psychotherapy, University of Rostock, Rostock, Germany

    Jacqueline Hoeppner & Sabine Christiane Herpertz

  2. Dept. of Neurology, University of Rostock, Gehlsheimer Str. 20, 18147, Rostock, Germany

    Lara Prudente-Morrissey, Reiner Benecke & Uwe Walter

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  1. Jacqueline Hoeppner
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  2. Lara Prudente-Morrissey
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  3. Sabine Christiane Herpertz
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  4. Reiner Benecke
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  5. Uwe Walter
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Correspondence to Uwe Walter.

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Hoeppner, J., Prudente-Morrissey, L., Herpertz, S.C. et al. Substantia nigra hyperechogenicity in depressive subjects relates to motor asymmetry and impaired word fluency. Eur Arch Psychiatry Clin Neurosci 259, 92–97 (2009). https://doi.org/10.1007/s00406-008-0840-9

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  • DOI: https://doi.org/10.1007/s00406-008-0840-9

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