Midbrain transcranial sonography in Korean patients with Parkinson's disease

Abstract

Transcranial sonography (TCS) is potentially useful for the diagnosis of Parkinson's disease (PD). However, studies on TCS have so far been restricted to European populations. To investigate the efficacy of TCS in Korean PD patients and its correlation with the clinical features, we carried out midbrain TCS in 43 PD patients and 35 normal controls and evaluated the area of the substantia nigra (SN) hyperechogenicity and its ratio to the area of the whole midbrain. In 16 subjects (21%), TCS was unsuccessful due to insufficient acoustic temporal bone windows. The mean area of bilateral SN hyperechogenicity and its ratio to the midbrain area were greater in the PD patients than that in the controls (P < 0.01). In the PD patients, the area of SN hyperechogenicity and its ratio to the individual midbrain area were moderately correlated with the PD duration (r = 0.526 and 0.536, P = 0.01, respectively) but not with the age, UPDRS motor scores or H-Y stage. There was no difference in the SN hyperechogenicity between the tremor-dominant, akinetic-rigid, and mixed-type PD patients. In conclusion, midbrain TCS is an effective diagnostic tool for detecting PD in the Korean population. However, it does not reflect the severity or phenotypes of parkinsonism.

Developments in the Role of Transcranial Sonography for the Differential Diagnosis of Parkinsonism

“…SN planimetric measurement has been shown to be accurate and reliable with little inter-rater variability [7]. To date different cut-offs values have been used and proposed to differentiate normal (SN−) and hyperechogenic (SN+) according to different devices and protocols [14][15][16][17].…”

Transcranial duplex in the differential diagnosis of parkinsonian syndromes

“…However, some authors calculated the mean of both sides [31][32][33]. Mostly, the area of increased signal intensity was measured to estimate whether the SN was normal or not.…”

Transcranial Sonography (TCS) of Brain Parenchyma in Movement Disorders: Quality Standards, Diagnostic Applications and Novel Technologies

“…In the case of a narrow transtemporal bone window, the transducer should be slightly shifted caudally -simultaneously with the upward tilting maneuver -in order to keep the bone window. Even if the bone window is poor, the pineal gland is mostly visible due General Electric/Logiq 9 3S/2.5 ≥ 0.20 Fedotova et al [22] Philips/HDI 5000 SonoCT P2 -4/2.5 ≥ 0.20 Kim et al [23] Philips/HP Sonos 5500 S4/2.0 -2.5 ≥ 0.20 ≥ 0. 27 Mehnert et al [17] Hagenah et al [18] Siemens/Acuson Antares PX4 -1/2.5 ≥ 0.24 ≥ 0.30 Van de Loo et al [10] Glaser et al [24] Siemens/Sonoline Elegra 2.5PL20/2.6 ≥ 0.20 ≥ 0.…”