engleski

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

Aims: While nigral substance (NS) is barely detectable in healthy individuals, majority of Parkinson disease (PD) patients displays its increased echogenicity by transcranial sonography (TCS). Aim was to asses the possibility of TCS measurement of NS to differentiate PD from movement disorders (MD). Patients and methods: TCS was possible in 56 out of 71 persons (79%). Data of 28 PD patients, 10 with MD: 4 with essential tremor, 2 with neuroleptic Parkinsonism, 4 with cervical dystonia and 18 age-matched controls were analyzed. TCS was applied by standardized protocol ; SN was displayed, encircled, measured two times. Mean area was calculated. Mann Whitney U test for inter-group comparison was applied. Results: NS was undetectable in 9 controls (50%) and in 2 (20%) with MD. Median SN size in controls was 0.17 cm2 (0.16 ; 0.21). Cut-off margin for detection hyperechogenicity was 0.21 cm2. Twenty-five PD patients (89%) exhibited combined hyperechogenic SN, 2 (20%) with MD and 3 (16%) controls. Data show statistically significant difference of NS echogenic size between PD and controls (Mann Whitney u=42 p<0, 001), as well as between MD and PD group (Mann Whitney u=23, 5 p<0, 001), but no difference between controls and MD group (Mann Whitney u=83, 0 p=0, 737). Discussion: Increased hyperechogenicity by TCS is a specific finding of PD and was not detected in other MD. One study confirmed absence of increased hyperechogenicity in essential tremor and one in supranuclear palsy. Neither CT nor MR imaging displayed such specific findings for PD. Conclusions: TCS finding of NS is valuable in differentiation PD from other MD.

transcranial sonogrpahy; Parkinson's disease; movement disorders

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