engleski

Transcranial sonography can discriminate Parkinson's disease from other movement disorders

While nigral substance (NS) is either barely detectable or undetectable in healthy individuals, majority of patients with Parkinson disease (PD) displays its increased echogenicity by means of transcranial sonography (TCS). Aim of this study is to asses the possibility of TCS to differentiate PD from other movement disorders by measurement of the NS. Methods: TCS was performed in 28 PD patients, 10 patients with movement disorders different from PD: 4 with essential tremor, 2 with neuroleptic Parkinsonism, 4 with cervical dystonia and 18 age matched healthy controls. Fifteen of them were excluded due to inappropriate temporal acoustic bone window. TCS was applied by standardized protocol ; NS was displayed, encircled, and measured two times. Mean area was calculated. Mann Whitney U test for inter-group comparison was applied. Results: TCS was possible in 56 out of 71 persons (79%). NS was undetectable or barely detectable in 9 healthy controls (50%), and in 2 (20%) with movement disorders. Median NS size in controls was 0.17 cm2 (0.16 ; 0.21). As cut-off margin for detection of hyperechogenicity 0.21 cm2 was used. Twenty-five PD patients (89%) exhibited combined hyperechogenic NS, 2 (20%) with movement disorders and 3 (16%) healthy individuals. Our data show statistically significant difference of NS echogenic size between PD patients and control group (Mann Whitney u=42 p<0, 001), as well as patients with movement disorder and PD group (Mann Whitney u=23, 5 p<0, 001) but no significant difference between controls and patients with movement disorders (Mann Whitney u=83, 0 p=0, 737). Conclusions: Assuming appropriate temporal "bone-window", measurement of NS by means of TCS is a valuable tool in differentiation PD from other movement disorders.

Parkinson disease -diagnosis; Parkinson disease - Ultrasonography; Ultrasonography; Doppler; transcranial; Neurologic examination

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