Parkinson’s disease

Logishetty, Kartik

doi:10.1007/978-1-84996-065-6_1

Cited by 1 publication

(4 citation statements)

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“…A clinical diagnosis after a six month follow-up was chosen as a gold diagnostic standard for PD [ 3 ]. When the diagnosis remained unclear clinically, or TCS results were doubtful and not consistent with the clinical findings, SPECT with presynaptic 123 I labelled Ioflupane ligand was employed.…”

Section: Methodsmentioning

confidence: 99%

“…Parkinson's disease (PD) is the second most prevalent neurodegenerative disease after Alzheimer's disease (AD) [ 1 ]. However, the diagnosis of PD or AD is based solely on the clinical criteria, as there is no accurate biological or imaging marker to date for either of them [ 1 - 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…But SPECT does not differentiate between PD and other causes of parkinsonism [ 2 ]. If the presynaptic ligands are used, it raises the sensitivity, but not the specificity for PD and syndromes [ 3 , 4 ]. Besides, SPECT is not widely available and limited in terms of safety [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…Both magnetic resonance imaging (MRI) and computed tomography (CT) are used to evaluate the structural changes of the brain. These imaging methods are not usually needed for the diagnosis, but find their place and value if parkinsonism is purely unilateral or otherwise atypical, which exclude secondary causes [ 3 ]. Both MRI and CT have their own limitations related to availability, costs, contraindications and safety (CT) [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Specificity of transcranial sonography in parkinson spectrum disorders in comparison to degenerative cognitive syndromes

et al. 2012

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BackgroundHyperechogenicity of the substantia nigra (SN+), detected by transcranial sonography (TCS), was reported as a characteristic finding in Parkinson's disease (PD), with high diagnostic accuracy values, when compared mainly to healthy controls or essential tremor (ET) group. However, some data is accumulating that the SN + could be detected in other neurodegenerative and even in non-neurodegenerative disorders too. Our aim was to estimate the diagnostic accuracy of TCS, mainly focusing on the specificity point, when applied to a range of the parkinsonian disorders, and comparing to the degenerative cognitive syndromes.MethodsA prospective study was carried out at the Hospital of Lithuanian University of Health Sciences from January until September 2011. Initially, a TCS and clinical examination were performed on 258 patients and 76 controls. The General Electric Voluson 730 Expert ultrasound system was used. There were 12.8% of cases excluded with insufficient temporal bones, and 4.3% excluded with an unclear diagnosis. The studied sample consisted of the groups: PD (n = 71, 33.2%), ET (n = 58, 27.1%), PD and ET (n = 10, 4.7%), atypical parkinsonian syndromes (APS) (n = 3, 1.4%), hereditary neurodegenerative parkinsonism (HDP) (n = 3, 1.4%), secondary parkinsonism (SP) (n = 23, 10.8%), mild cognitive impairment (MCI) (n = 33, 15.4%), dementia (n = 13, 6.1%), and control (n = 71).ResultsThere were 80.3% of PD patients at stages 1 & 2 according to Hoehn and Yahr. At the cut-off value of 0.20 cm2 of the SN+, the sensitivity for PD was 94.3% and the specificity - 63.3% (ROC analysis, AUC 0.891), in comparison to the rest of the cohort. At the cut-off value of 0.26 cm2, the sensitivity was 90% and the specificity 82.4%.The estimations for the lowest specificity for PD, in comparison to the latter subgroups (at the cut-off values of 0.20 cm2 and 0.26 cm2, respectively) were: 0% and 33.3% to APS, 33.3% and 66.7% to HDP, 34.8% and 69.6% to SP, 55.2% and 82.8% to ET, 75% and 91.7% to dementia.ConclusionsThe high sensitivity of the test could be employed as a valuable screening tool. But TCS is more useful as a supplementary diagnostic method, due to the specificity values not being comprehensive.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%