1
|
Gao H, Qu Y, Chen S, Yang Q, Li J, Tao A, Mao Z, Xue Z. Third ventricular width by transcranial sonography is associated with cognitive impairment in Parkinson's disease. CNS Neurosci Ther 2024; 30:e14360. [PMID: 37448105 PMCID: PMC10848047 DOI: 10.1111/cns.14360] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 06/09/2023] [Accepted: 07/01/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND One-fourth of Parkinson's disease (PD) patients suffer from cognitive impairment. However, few neuroimaging markers have been identified regarding cognitive impairment in PD. OBJECTIVE This study aimed to explore the association between third ventricular width by transcranial sonography (TCS) and cognitive decline in PD. METHOD Participants with PD were recruited from one medical center in China. Third ventricular width was assessed by TCS, and cognitive function was analyzed by the Mini-Mental State Examination (MMSE). Receiver operating characteristic (ROC) analysis and Cox model analysis were utilized to determine the diagnostic and predictive accuracy of third ventricular width by TCS for cognitive decline in PD patients. RESULT A total of 174 PD patients were recruited. Third ventricular width was negatively correlated with MMSE scores. ROC analysis suggested that the optimal cutoff point for third ventricular width in screening for cognitive impairment in PD was 4.75 mm (sensitivity 62.7%; specificity 75.6%). After 21.5 (18.0, 26.0) months of follow-up in PD patients without cognitive impairment, it was found that those with a third ventricular width greater than 4.75 mm exhibited a 7.975 times higher risk of developing cognitive impairment [hazard ratio = 7.975, 95% CI 1.609, 39.532, p = 0.011] compared with patients with a third ventricular width less than 4.75 mm. CONCLUSION Third ventricular width based on TCS emerged as an independent predictor of developing cognitive impairment in PD patients.
Collapse
Affiliation(s)
- Hong‐ling Gao
- Department of Neurology, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Yi Qu
- Department of Neurology, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Sheng‐chong Chen
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Qing‐mei Yang
- Department of Neurology, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Jing‐yi Li
- Department of Neurology, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - An‐yu Tao
- Department of Ultrasound, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Zhi‐juan Mao
- Department of Neurology, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Zheng Xue
- Department of Neurology, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| |
Collapse
|
2
|
Ultrasonographic Changes in Brain Hemodynamics in Patients with Parkinson's Disease and Risk Factors for Cerebrovascular Disease: A Pilot Study. PARKINSONS DISEASE 2021; 2021:1713496. [PMID: 34650786 PMCID: PMC8510819 DOI: 10.1155/2021/1713496] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 09/20/2021] [Accepted: 09/24/2021] [Indexed: 12/13/2022]
Abstract
Recent epidemiological studies have revealed a correlation between atypical features and worse functional outcomes in Parkinson's disease (PD) patients with cerebrovascular disease (CVD). We aimed to evaluate the brain hemodynamics of PD patients with risk factors for CVD using Doppler ultrasonography. In this prospective pilot study, we randomly included 27 outpatients diagnosed with PD. Transcranial color-coded sonography (TCCS) examinations were performed, obtaining measurements of middle cerebral artery mean flow velocities (Vm), the resistance index (RI), and the pulsatility index (PI). The breath-holding index (BHI) was used to assess cerebrovascular reactivity (cVR). Standardized functional scales (UPDRS III, Hoehn & Yahr scale, and MoCA) were administered. The patients were divided into two groups: those with two or more vascular risk factors (PDvasc) and those with fewer than two vascular risk factors (PDnvasc). Patients in the PDvasc group showed higher PI (1.00 vs. 0.85; p=0.020), RI (0.59 vs. 0.5; p=0.05), H&Y mean (2.4 vs. 1.4; p=0.036), higher frequency of altered cVR (90.9% vs. 25.0%; p=0.001), and lower BHI (0.46 vs. 1.01; p=0.027). We also divided the patients in other two groups: one with patients with classical and another with akinetic-rigid PD clinical type. Patients with the akinetic-rigid type of PD had significantly higher RI (0.60 vs. 0.51; p=0.03), PI (0.99 vs. 0.77; p=0.03), higher frequency of altered cVR (80% vs. 35%; p=0.02), and lower BHI (0.48 vs. 0.96; p=0.05) than patients with classic-type PD. We concluded that TCCS displays impaired cerebrovascular reactivity and a more severe disease pattern in Parkinsonian patients with two or more risk factors for CVD and in the akinetic-rigid type. Doppler ultrasonography may be a useful tool in a clinical setting to investigate PD patients.
Collapse
|
3
|
Tao A, Chen G, Mao Z, Gao H, Deng Y, Xu R. Essential tremor vs idiopathic Parkinson disease: Utility of transcranial sonography. Medicine (Baltimore) 2020; 99:e20028. [PMID: 32443307 PMCID: PMC7254097 DOI: 10.1097/md.0000000000020028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Substantia nigra (SN) hyperechogenicity measured by transcranial sonography (TCS) is a promising biomarker for Parkinson disease (PD). The aim of this study was to explore the diagnostic accuracy of SN hyperechogenicity (SN) for differentiating PD from essential tremor (ET). A total of 119 patients with PD, 106 ET patients and 112 healthy controls that underwent TCS from November 2016 to February 2019 were included in this single-center retrospective case-control study. Two reviewers who were blinded to clinical information independently measured the SN by TCS imaging. The diagnostic sensitivity, specificity, and accuracy of TCS imaging were evaluated between the PD and healthy controls and between patients with PD and ET. Interrater agreement was assessed with the Cohen κ statistic. TCS imaging of the SN allowed to differentiate between patients with PD and ET with a sensitivity (91.6% and 90.8%) and specificity (91.5% and 89.6%) for readers 1 and 2, respectively. Interobserver agreement was excellent (к = 0.87). In addition, measurement of the SN allowed to differentiate between patients with PD and healthy subjects with a sensitivity (91.6% and 90.8%) and specificity (88.4% and 89.3%) for readers 1 and 2, respectively. Interobserver agreement was excellent (к = 0.91). Measurement of SN on TCS images could be a useful tool to distinguishing patients with PD from those with ET.
Collapse
Affiliation(s)
- Anyu Tao
- Department of Medical Ultrasound
| | - Guangzhi Chen
- Division of Cardiology, Department of Internal Medicine
| | - Zhijuan Mao
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongling Gao
- Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | | | | |
Collapse
|
4
|
MEETING REPORTER. Curr Opin Neurol 2018; 30 Suppl 1:1-24. [DOI: 10.1097/wco.0000000000000521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
5
|
Li X, Xue S, Jia S, Zhou Z, Qiao Y, Hou C, Wei K, Zheng W, Rong P, Jiao J. Transcranial sonography in idiopathic REM sleep behavior disorder and multiple system atrophy. Psychiatry Clin Neurosci 2017; 71:238-246. [PMID: 27898200 DOI: 10.1111/pcn.12483] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 10/09/2016] [Accepted: 11/14/2016] [Indexed: 11/30/2022]
Abstract
AIM We investigated preclinical abnormalities as revealed by transcranial sonography (TCS) in patients with idiopathic rapid eye movement sleep behavior disorder (iRBD) compared with those revealed in patients with multiple system atrophy (MSA) or Parkinson's disease (PD) and in normal controls. METHODS Twenty-two patients with iRBD, 21 patients with MSA, 22 patients with PD, and 21 normal controls were included in this study. All participants underwent one night of video-polysomnography monitoring, and the sleep parameters were analyzed using Polysmith software and by visual analysis. TCS was performed following a standardized procedure. The echogenicity of the substantia nigra and basal ganglia were evaluated. RESULTS A greater proportion of PD patients were found to have substantia nigra hyperechogenicity (86.4%) when compared to iRBD patients (31.8%), MSA patients (23.8%), and normal controls (4.8%) (P < 0.001). Fourteen MSA patients (66.7%) and 11 iRBD patients (50.0%) had hyperechogenicity in the basal ganglia, whereas hyperechogenicity in the basal ganglia was less frequent in PD patients (18.2%) and normal controls (9.5%) (P < 0.001). Poor sleep efficiency, less stage II sleep time, and more periodic leg movements were found in MSA and PD patients, whereas iRBD patients had almost normal sleep. CONCLUSION Some iRBD patients had basal ganglia hyperechogenicity that was similar to that observed in MSA, which may represent another possible convert direction. The present study further confirmed iRBD as a prodromal stage of synucleinopathy. TCS could detect subclinical changes and thus might provide useful markers for identifying individuals at increased risk for developing a synucleinopathy.
Collapse
Affiliation(s)
- Xudong Li
- Department of Neurology and, China-Japan Friendship Hospital, Beijing, China
| | - Shuang Xue
- Department of Neurology and, China-Japan Friendship Hospital, Beijing, China
| | - Shuhong Jia
- Department of Neurology and, China-Japan Friendship Hospital, Beijing, China
| | - Zhi Zhou
- Department of Senior Official Ward, China-Japan Friendship Hospital, Beijing, China
| | - Yanan Qiao
- Department of Neurology and, China-Japan Friendship Hospital, Beijing, China
| | - Chunlei Hou
- Department of Neurology and, China-Japan Friendship Hospital, Beijing, China
| | - Kun Wei
- Department of Neurology and, China-Japan Friendship Hospital, Beijing, China
| | - Wenjing Zheng
- Department of Neurology and, China-Japan Friendship Hospital, Beijing, China
| | - Pei Rong
- Department of Neurology and, China-Japan Friendship Hospital, Beijing, China
| | - Jinsong Jiao
- Department of Neurology and, China-Japan Friendship Hospital, Beijing, China
| |
Collapse
|
6
|
Fernandes RDCL, Rosso ALZD, Vincent MB, Araújo NC. Use of Gray-Level Histograms to Assess Substantia Nigra Echogenicity in Transcranial Sonography Images of Parkinson Disease Patients. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2016. [DOI: 10.1177/8756479316667083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A substantial body of research has shown that Parkinson disease (PD) patients display an enlarged hyperechogenic substantia nigra (SN) by transcranial sonography (TCS). Nonetheless, the categorization of SN echogenicity is still subjective. A method is described to quantify SN echogenicity based on the gray-level histograms of digitized TCS images. In 31 PD patients and 57 controls, the gray-scale mean (GSM) of the SN, mesencephalon, and basal cisterns and their ratios were assessed using image-editing computer software. The GSM values were compared between the groups and correlated with age, SN area, and disease duration. The SN GSM was significantly higher in the PD group ( P < .05) with a positive correlation with age but not with disease duration. In this cohort of participants, mesencephalon echogenicity was found to increase with disease duration. These results would suggest quantitatively SN hyperechogenicity in PD. Quantifying SN echogenicity is feasible and might minimize subjectivity in PD diagnosis by TCS. The method has the potential to disclose subtle changes in other midbrain structures’ echogenicity engendered by the disease process as well.
Collapse
|
7
|
|
8
|
Bouwmans AEP, Weber WEJ, Leentjens AFG, Mess WH. Transcranial sonography findings related to depression in parkinsonian disorders: cross-sectional study in 126 patients. PeerJ 2016; 4:e2037. [PMID: 27231659 PMCID: PMC4878362 DOI: 10.7717/peerj.2037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 04/23/2016] [Indexed: 12/02/2022] Open
Abstract
Background. Transcranial sonography (TCS) has emerged as a potential diagnostic tool for Parkinson’s disease. Recent research has suggested that abnormal echogenicity of substantia nigra, raphe nuclei and third ventricle is associated with increased risk of depression among these patients. We sought to reproduce these findings in an ongoing larger study of patients with parkinsonian syndromes. Methods. A total of 126 patients with parkinsonian symptoms underwent the Hamilton Depression Scale, and TCS of the substantia nigra (SN) (n = 126), the raphe nuclei (RN) (n = 80) and the third ventricle (n = 57). We then calculated the correlation between depression and hyper-echogenic SN, hypo-echogenic RN and a wider third ventricle. Results. In patients with PD we found no significant difference of the SN between non-depressed and depressed patients (46% vs. 22%; p = 0.18). Non-depressed patients with other parkinsonisms more often had hyperechogenicity of the SN than depressed patients (51% vs. 0%; p = 0.01). We found no relation between depression and the echogenicity of the RN or the width of the third ventricle. Conclusions. In patients with parkinsonian syndromes, we found no association between depression and hyper-echogenic SN, hypo-echogenic RN or a wider third ventricle, as determined by transcranial sonography.
Collapse
Affiliation(s)
| | - Wim E J Weber
- Department of Neurology, Maastricht University Medical Centre , Maastricht , Netherlands
| | - Albert F G Leentjens
- Department of Psychiatry, Maastricht University Medical Centre , Maastricht , Netherlands
| | - Werner H Mess
- Department of Clinical Neurophysiology, Maastricht University Medical Centre , Maastricht , Netherlands
| |
Collapse
|
9
|
Pilotto A, Yilmaz R, Berg D. Developments in the role of transcranial sonography for the differential diagnosis of parkinsonism. Curr Neurol Neurosci Rep 2016; 15:43. [PMID: 26008814 DOI: 10.1007/s11910-015-0566-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In the last two decades transcranial sonography (TCS) has developed as a valuable, supplementary tool in the diagnosis and differential diagnosis of movement disorders. In this review, we highlight recent evidence supporting TCS as a reliable method in the differential diagnosis of parkinsonism, combining substantia nigra (SN), basal ganglia and ventricular system findings. Moreover, several studies support SN hyperechogenicity as one of most important risk factors for Parkinson's disease (PD). The advantages of TCS include short investigation time, low cost and lack of radiation. Principal limitations are still the dependency on the bone window and operator experience. New automated algorithms may reduce the role of investigator skill in the assessment and interpretation, increasing TCS diagnostic reliability. Based on the convincing evidence available, the EFNS accredited the method of TCS a level A recommendation for supporting the diagnosis of PD and its differential diagnosis from secondary and atypical parkinsonism. An increasing number of training programmes is extending the use of this technique in clinical practice.
Collapse
Affiliation(s)
- Andrea Pilotto
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | | | | |
Collapse
|
10
|
Suwijn SR, van Boheemen CJM, de Haan RJ, Tissingh G, Booij J, de Bie RMA. The diagnostic accuracy of dopamine transporter SPECT imaging to detect nigrostriatal cell loss in patients with Parkinson's disease or clinically uncertain parkinsonism: a systematic review. EJNMMI Res 2015; 5:12. [PMID: 25853018 PMCID: PMC4385258 DOI: 10.1186/s13550-015-0087-1] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 02/19/2015] [Indexed: 02/08/2023] Open
Abstract
In specialized movement disorder centers, Parkinson's disease (PD) is wrongly diagnosed in 6 to 25% of cases. To improve the accuracy of the clinical diagnosis, it is necessary to have a reliable and practical reference standard. Dopamine transporter single-photon emission computed tomography (DAT SPECT) imaging might have the potential (high diagnostic accuracy and practical to use) to act as reference standard in detecting nigrostriatal cell loss in patients with (early stage) parkinsonism. We performed a systematic review to evaluate if DAT SPECT imaging can be used as such. Relevant studies were searched in the MEDLINE and EMBASE databases. Studies were selected when they met the following criteria: (1) all patients were adults with a clinical diagnosis of PD or clinically uncertain parkinsonism and (2) the study reported original data. In addition, studies needed to fulfill one of the two following criteria: (1) patients underwent at least one DAT SPECT and had a neuropathological confirmed diagnosis and (2) patients underwent at least two DAT SPECT scans, performed at least 2 years apart. The search identified 1,649 articles. Eight studies fulfilled our selection criteria and were included in this review. There was only one study including patients with diagnostic uncertainty. Sensitivity and specificity of DAT SPECT imaging to detect nigrostriatal cell loss were 98%. The other studies included patients with a diagnosis of PD in whom there was no uncertainty. In these studies, sensitivity was 100%. Our systematic review indicates that DAT SPECT imaging seems to be accurate to detect nigrostriatal cell loss in patients with parkinsonism.
Collapse
Affiliation(s)
- Sven R Suwijn
- />Department of Neurology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, PO Box 22660, 1100 DD Amsterdam, The Netherlands
| | - Caroline JM van Boheemen
- />Department of Neurology, Medical Center Haaglanden, Lijnbaan 32, PO Box 432, 2501 CK The Hague, The Netherlands
| | - Rob J de Haan
- />Department of Clinical Research Unit, Academic Medical Center, University of Amsterdam, Meibergdreef 9, PO Box 22660, 1100 DD Amsterdam, The Netherlands
| | - Gerrit Tissingh
- />Department of Neurology, Atrium Medical Center Parkstad, Henri Dunantstraat 5, PO Box 4446, 6401 CX Heerlen, The Netherlands
| | - Jan Booij
- />Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, Meibergdreef 9, PO Box 22660, 1100 DD Amsterdam, The Netherlands
| | - Rob MA de Bie
- />Department of Neurology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, PO Box 22660, 1100 DD Amsterdam, The Netherlands
| |
Collapse
|
11
|
Diagnosis and differential diagnosis of MSA: boundary issues. J Neurol 2015; 262:1801-13. [PMID: 25663409 DOI: 10.1007/s00415-015-7654-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 01/22/2015] [Accepted: 01/23/2015] [Indexed: 12/30/2022]
Abstract
Because the progression of multiple system atrophy (MSA) is usually rapid and there still is no effective cause-related therapy, early and accurate diagnosis is important for the proper management of patients as well as the development of neuroprotective agents. However, despite the progression in the field of MSA research in the past few years, the diagnosis of MSA in clinical practice still relies largely on clinical features and there are limitations in terms of sensitivity and specificity, especially in the early course of the disease. Furthermore, recent pathological, clinical, and neuroimaging studies have shown that (1) MSA can present with a wider range of clinical and pathological features than previously thought, including features considered atypical for MSA; thus, MSA can be misdiagnosed as other diseases, and conversely, disorders with other etiologies and pathologies can be clinically misdiagnosed as MSA; and (2) several investigations may help to improve the diagnosis of MSA in clinical practice. These aspects should be taken into consideration when revising the current diagnostic criteria. This is especially true given that disease-modifying treatments for MSA are under investigation.
Collapse
|
12
|
Tunc S, Graf J, Tadic V, Brüggemann N, Schmidt A, Al-Khaled M, Wolff S, Vollstedt EJ, Lorwin A, Hampf J, Piskol L, Klein C, Hagenah J, Kasten M. A population-based study on combined markers for early Parkinson's disease. Mov Disord 2014; 30:531-7. [DOI: 10.1002/mds.26100] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 10/07/2014] [Accepted: 10/26/2014] [Indexed: 11/07/2022] Open
Affiliation(s)
- Sinem Tunc
- Department of Psychiatry and Psychotherapy; University of Luebeck; Germany
- Institute of Neurogenetics; University of Luebeck; Germany
| | - Julia Graf
- Institute of Neurogenetics; University of Luebeck; Germany
| | - Vera Tadic
- Institute of Neurogenetics; University of Luebeck; Germany
| | | | | | | | - Simone Wolff
- Institute of Neurogenetics; University of Luebeck; Germany
| | - Eva-Juliane Vollstedt
- Department of Psychiatry and Psychotherapy; University of Luebeck; Germany
- Institute of Neurogenetics; University of Luebeck; Germany
| | - Anne Lorwin
- Department of Psychiatry and Psychotherapy; University of Luebeck; Germany
- Institute of Neurogenetics; University of Luebeck; Germany
| | - Jennie Hampf
- Department of Psychiatry and Psychotherapy; University of Luebeck; Germany
- Institute of Neurogenetics; University of Luebeck; Germany
| | - Linda Piskol
- Institute of Neurogenetics; University of Luebeck; Germany
| | | | - Johann Hagenah
- Department of Neurology; Westkuestenklinikum Heide Heide Germany
| | - Meike Kasten
- Department of Psychiatry and Psychotherapy; University of Luebeck; Germany
- Institute of Neurogenetics; University of Luebeck; Germany
| |
Collapse
|
13
|
Ries V, Vadasz D, Belke M, Oertel W, Knake S. Bildgebende Verfahren als Biomarker der Neurodegeneration bei der REM-Schlafverhaltensstörung. SOMNOLOGIE 2014. [DOI: 10.1007/s11818-014-0686-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
14
|
Iranzo A, Stockner H, Serradell M, Seppi K, Valldeoriola F, Frauscher B, Molinuevo JL, Vilaseca I, Mitterling T, Gaig C, Vilas D, Santamaria J, Högl B, Tolosa E, Poewe W. Five-year follow-up of substantia nigra echogenicity in idiopathic REM sleep behavior disorder. Mov Disord 2014; 29:1774-80. [PMID: 25384461 DOI: 10.1002/mds.26055] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 09/25/2014] [Accepted: 09/26/2014] [Indexed: 11/07/2022] Open
Abstract
Hyperechogenicity of the substantia nigra visualized by transcranial sonography occurs in most Parkinson's disease (PD) patients. Idiopathic rapid eye movement (REM) sleep behavior disorder (IRBD) subjects eventually develop PD and other synucleinopathies. This study was undertaken to evaluate whether in IRBD, transcranial sonography identifies subjects who convert to PD and other synucleinopathies, and whether substantia nigra echogenic size changes with time. It was a prospective study in which 55 IRBD patients underwent transcranial sonography at baseline and were invited to follow-up after 5 years. Patients were assessed by the same experienced sonographer who was blinded to clinical data and baseline transcranial sonography results, and used the same equipment and adjustments. Twenty-one (38.2%) subjects were diagnosed with a synucleinopathy (PD in 11, dementia with Lewy bodies in nine, and multiple system atrophy in one). Sensitivity of baseline substantia nigra hyperechogenicity for the development of a synucleinopathy was 42.1%, specificity 67.7%, positive predictive value 44.4%, negative predictive value 65.6%, and relative risk 1.29. No differences were detected between the first and second examination in mean size of the substantia nigra (0.20 ± 0.09 cm(2) vs. 0.19 ± 0.07 cm(2) ; P = 0.777) and in percentage of patients with substantia nigra hyperechogenicity (33.3% vs. 42.8%, P = 0.125). Transcranial sonography of the substantia nigra alone is not a useful tool to identify IRBD subjects at risk for the development of PD or a synucleinopathy after 5 years of follow-up. In IRBD, transcranial sonography cannot be used to monitor the degenerative process in the substantia nigra, because echogenicity size remains stable over time.
Collapse
Affiliation(s)
- Alex Iranzo
- Neurology Service, Hospital Clinic de Barcelona, IDIBAPS, CIBERNED, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Hellwig S, Reinhard M, Amtage F, Guschlbauer B, Buchert R, Tüscher O, Weiller C, Niesen WD, Meyer PT. Transcranial sonography and [18F]fluorodeoxyglucose positron emission tomography for the differential diagnosis of parkinsonism: a head-to-head comparison. Eur J Neurol 2014; 21:860-6. [PMID: 24602186 DOI: 10.1111/ene.12394] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 01/28/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Brain imaging with positron emission tomography using [(18) F]fluorodeoxyglucose (FDG-PET) and transcranial B-mode sonography (TCS) improves the differential diagnosis of parkinsonism. The diagnostic merits of these approaches in identifying and differentiating atypical parkinsonian syndromes (APS) are compared. METHODS Data were included from 36 patients with clinically suspected APS who underwent PET and TCS. FDG-PET scans were analyzed by visual assessment (including voxel-based statistical maps) of a priori defined disease-specific metabolic patterns. Sonographers achieved diagnoses according to pre-defined criteria for echogenicities of the substantia nigra and lenticular nucleus, and third ventricle diameter. Patients with APS were identified and allocated to the subgroups multiple system atrophy (MSA), progressive supranuclear palsy (PSP) or corticobasal degeneration (CBD). RESULTS After a median follow-up period of 9 months, the final clinical diagnoses (reference standard) were Parkinson's disease, n = 15; MSA, n = 9; PSP, n = 7; and CBD, n = 5 (n = 21 APS in total). Six patients (4 APS) showed an insufficient bone window for TCS. In the remaining 30 patients, sensitivity/specificity for diagnosing APS were 82%/100% and 82%/85% for FDG-PET and TCS, respectively. Diagnostic accuracies did not differ between FDG-PET (90%) and TCS (83%; P = 0.69). Likewise, overall accuracy of subgroup classification (non-APS, MSA, PSP and CBD) did not differ between modalities (FDG-PET 87% and TCS 83%; P = 1.00). CONCLUSIONS FDG-PET and TCS show comparable accuracies for differential diagnosis of neurodegenerative parkinsonism. This preliminary study supports the use of TCS and warrants further prospective validation.
Collapse
Affiliation(s)
- S Hellwig
- Department of Neurology, University Hospital Freiburg, Freiburg, Germany; Department of Psychiatry and Psychotherapy, University Hospital Freiburg, Freiburg, Germany
| | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Mavrogiorgou P, Nalato F, Meves S, Luksnat S, Norra C, Gold R, Juckel G, Krogias C. Transcranial sonography in obsessive-compulsive disorder. J Psychiatr Res 2013; 47:1642-8. [PMID: 23932243 DOI: 10.1016/j.jpsychires.2013.07.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 07/07/2013] [Accepted: 07/16/2013] [Indexed: 01/04/2023]
Abstract
There is convergent evidence that basal ganglia structures are involved in the pathogenesis of obsessive-compulsive disorder (OCD). It has been also assumed that OCD is caused by a central serotonergic dysfunction. Transcranial sonography (TCS) has become a reliable, sensitive and non-invasive diagnostic tool concerning the evaluation of extrapyramidal movement disorders. This study used TCS to examine the alterations in different parenchymal regions, especially concerning serotonergic brainstem raphe nuclei as well as basal ganglia in OCD. Thirty-one OCD patients were compared with 31 matched healthy controls. Echogenecities were investigated according to the examination protocol for extrapyramidal disorders using a Siemens Sonoline(®) Elegra system. Obsessive-compulsive disorder patients showed reduced echogenity of the serotonergic brainstem raphe nuclei (32.3%) compared with healthy controls (16.1%). In nine OCD-patients (31%), but only in 2 control subjects (6.2%), a hyperechogenicity of the caudate nucleus was found. Patients with OCD significantly more often reveal a hypoechogenic brainstem raphe possibly reflecting altered serotonergic neurons there and a hyperechogenicity of caudate nucleus indicating structural or molecular cell changes. Further research is warranted to examine, whether TCS is useful in order to classify OCD and its subtypes.
Collapse
Affiliation(s)
- Paraskevi Mavrogiorgou
- Dept. of Psychiatry, Ruhr University Bochum, LWL-Universitätsklinikum, Alexandrinenstr. 1, 44791 Bochum, Germany
| | | | | | | | | | | | | | | |
Collapse
|
17
|
Krogias C, Fischer G, Meves SH, Gold R, Juckel G, Norra C. Brainstem Raphe Alterations Depicted by Transcranial Sonography Do Not Result in Serotonergic Functional Impairment. J Neuroimaging 2013; 23:477-83. [DOI: 10.1111/jon.12038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 02/15/2013] [Accepted: 03/03/2013] [Indexed: 11/28/2022] Open
Affiliation(s)
- Christos Krogias
- Department of Neurology; Ruhr University Bochum, St. Josef-Hospital; Gudrunstr 56 44791 Bochum Germany
| | - Gerrit Fischer
- Department of Psychiatry; Ruhr University, LWL-Universitätsklinik; Alexandrinenstr. 1 44791 Bochum Germany
| | - Saskia H. Meves
- Department of Neurology; Ruhr University Bochum, St. Josef-Hospital; Gudrunstr 56 44791 Bochum Germany
| | - Ralf Gold
- Department of Neurology; Ruhr University Bochum, St. Josef-Hospital; Gudrunstr 56 44791 Bochum Germany
| | - Georg Juckel
- Department of Psychiatry; Ruhr University, LWL-Universitätsklinik; Alexandrinenstr. 1 44791 Bochum Germany
| | - Christine Norra
- Department of Psychiatry; Ruhr University, LWL-Universitätsklinik; Alexandrinenstr. 1 44791 Bochum Germany
| |
Collapse
|
18
|
Olivares Romero J, Arjona Padillo A, Barrero Hernández FJ, Martín González M, Gil Extremera B. Utility of transcranial sonography in the diagnosis of drug-induced parkinsonism: a prospective study. Eur J Neurol 2013; 20:1451-8. [DOI: 10.1111/ene.12131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 01/30/2013] [Indexed: 12/19/2022]
|
19
|
Sakalauskas A, Lukoševičius A, Laučkaitė K, Jegelevičius D, Rutkauskas S. Automated segmentation of transcranial sonographic images in the diagnostics of Parkinson's disease. ULTRASONICS 2013; 53:111-121. [PMID: 22578750 DOI: 10.1016/j.ultras.2012.04.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Revised: 03/29/2012] [Accepted: 04/15/2012] [Indexed: 05/31/2023]
Abstract
Images captured during routine clinical transcranial sonography (TCS) examination are of a low resolution, so can be confusing for diagnostic evaluations. Manual segmentation of brain structures (areas of the midbrain and substantia nigra (SN)) that are of special interest cause inter-observer and intra-observer variability, thus restricting the reliability of Parkinson disease (PD) diagnostics. This paper presents a new technique for automated segmentation applicable to low resolution sonographic images, and particularly to brain structures related to PD. The segmentation was performed by a modified shape-based active contour (AC) segmentation algorithm. In order to suppress the speckle noise and to improve the AC segmentation, a pre-processing technique based on the averaging of adjusted spatially varying TCS images is proposed. The latter technique was tested on clinical TCS images. The results of the automated segmentation were compared with the manual markings. Two experts on the 40TCS images performed these markings. The comparison showed that an automated method is effective when segmentation of the midbrain is performed (averaged overlap between regions obtained automatically and outlined manually was 73.10±7.45%). The results of the segmentation of the SN area showed that a sufficiently correct contour of this area could also be obtained, but the accuracy of the segmentation is related to the image quality. It should be emphasised that the main difficulty in evaluating the accuracy of automated segmentation of the SN was the indefinite "gold standard" (variation between the measurements of two experts with different experience was found). And, therefore, the diagnostic reliability of the proposed technique was inconclusive.
Collapse
Affiliation(s)
- Andrius Sakalauskas
- Biomedical Engineering Institute, Kaunas University of Technology, Studentu Str. 65, Kaunas LT-51359, Lithuania.
| | | | | | | | | |
Collapse
|
20
|
Fernandes RDCL, Rosso ALZD, Vincent MB, Bahia PRV, Resende CMC, Araujo NC. Achados de ultrassonografia transcraniana na doença de Parkinson e no tremor essencial: relato de casos. Radiol Bras 2012. [DOI: 10.1590/s0100-39842012000600014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A ultrassonografia transcraniana tem sido objeto de investigação como ferramenta diagnóstica em neurologia nos últimos anos. Ela permite boa visualização de estruturas cerebrais situadas na linha média, sítio frequente de anormalidades nas doenças do movimento. Relatamos os casos de pacientes com a doença de Parkinson e o tremor essencial em que a ultrassonografia transcraniana foi capaz de sugerir o diagnóstico.
Collapse
|
21
|
Brüggemann N, Külper W, Hagenah J, Bauer P, Pattaro C, Tadic V, Lohnau T, Winkler S, Tönnies H, Sprenger A, Pramstaller P, Rolfs A, Siebert R, Riess O, Vieregge P, Lohmann K, Klein C. Autosomal dominant Parkinson's disease in a large German pedigree. Acta Neurol Scand 2012; 126:129-37. [PMID: 22107061 DOI: 10.1111/j.1600-0404.2011.01621.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE While several genes have been identified to cause Parkinson's disease (PD), monogenic forms explain only a small proportion of cases. We report clinical and genetic results in a large family with late-onset autosomal dominant PD. METHODS Thirty-eight family members of a five-generation Northern German PD family underwent a detailed neurologic examination, and transcranial sonography was performed in fifteen of them. Comprehensive mutation analysis of known PD-causing genes and a genome-wide linkage analysis were performed. RESULTS Late-onset definite PD was found in five subjects with a mean age at onset of 63 years. Another six individuals presented either with probable/possible PD or with subtle parkinsonian signs. Six members with a mean age of 79 years had an essential tremor phenotype. Mode of PD inheritance was compatible with autosomal dominant transmission. One of three examined patients with definite PD demonstrated an increased area of substantia nigra hyperechogenicity upon transcranial sonography. Comprehensive linkage and mutational analysis excluded mutations in known PD-causing genes. Genome-wide linkage analysis suggested a putative disease gene in an 11.3-Mb region on chromosome 7p15-21.1 with a multipoint LOD score of 2.0. CONCLUSIONS The findings in this family further demonstrate genetic heterogeneity in familial autosomal dominant late-onset PD.
Collapse
Affiliation(s)
- N Brüggemann
- Division of Clinical and Molecular Neurogenetics at the Department of Neurology, University of Lübeck, Lübeck, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Fernandes RDCL, Rosso ALZD, Vincent MB, Silva KSD, Bonan C, Araújo NC, Berg D. Transcranial sonography as a diagnostic tool for Parkinson's disease: a pilot study in the city of Rio de Janeiro, Brazil. ARQUIVOS DE NEURO-PSIQUIATRIA 2011; 69:892-5. [DOI: 10.1590/s0004-282x2011000700008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2011] [Accepted: 07/07/2011] [Indexed: 11/22/2022]
Abstract
In Brazil there is no systematic study on Transcranial Sonography (TCS), a neuroimaging method that depicts echogenic deep brain structures using ultrasound. OBJECTIVE: To establish the percentage of subjects with permissive temporal windows and to address the ability of TCS of the substantia nigra (SN) to distinguish parkinsonian patients in a Brazilian sample. METHOD: We performed TCS using the Acuson X300 (Siemens, Germany) in 37 individuals: 23 with Parkinson's disease (PD) and 14 healthy controls. RESULTS: 10.8% of subjects had insufficient temporal acoustic bone windows. SN echogenic areas were larger in patients (mean±SD, 0.31±0.08cm²) compared to controls (mean±SD, 0.17±0.02cm²). TCS accurately identified 88.2% of PD patients. CONCLUSION: A large proportion of Brazilians seem to be eligible for TCS. An expressive number of PD patients could be diagnosed by TCS based on an expanded SN echogenic area. However, the current data is preliminary and must be corroborated by larger studies.
Collapse
|
23
|
LeWitt P, Schultz L, Auinger P, Lu M. CSF xanthine, homovanillic acid, and their ratio as biomarkers of Parkinson's disease. Brain Res 2011; 1408:88-97. [PMID: 21784416 PMCID: PMC4120020 DOI: 10.1016/j.brainres.2011.06.057] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Revised: 06/22/2011] [Accepted: 06/24/2011] [Indexed: 11/28/2022]
Abstract
Diminished nigrostriatal dopaminergic neurotransmission is a biochemical hallmark of Parkinson's disease. Despite this, a reliable trait biomarker of sporadic Parkinson's disease has not emerged from measurements of cerebrospinal fluid dopamine metabolites. Previous studies have highlighted strong neurochemical relationships between dopamine and various purine compounds. In this study, we analyzed cerebrospinal fluid concentrations of homovanillic acid (the major catabolite of dopamine) and the purine compound xanthine for a comparison of 217 unmedicated Parkinson's disease subjects and 26 healthy controls. These compounds were highly correlated for both the Parkinson's disease subjects (r=0.68) and for controls (r=0.73; both groups, p<0.001). While neither homovanillic acid nor xanthine concentrations differentiated Parkinson's disease from controls, their ratio did. For controls, the mean [xanthine]/[homovanillic acid] quotient was 13.1±5.5 as compared to the Parkinson's disease value of 17.4±6.7 at an initial lumbar CSF collection (p=0.0017), and 19.7±8.7 (p<0.001) at a second CSF collection up to 24 months later. The [xanthine]/[homovanillic acid] ratio in the Parkinson's disease subjects differed as a function of disease severity, as measured by the sum of Unified Parkinson's Disease Rating Scale Activities of Daily Living and Motor Exam ratings. The [xanthine]/[homovanillic acid] ratio also increased between the first and second CSF collections, suggesting that this quotient provides both a state and trait biomarker of Parkinson's disease. These observations add to other neurochemical evidence that links purine metabolism to Parkinson's disease.
Collapse
Affiliation(s)
- Peter LeWitt
- Department of Neurology, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA
- The Department of Neurology, Wayne State University School of Medicine, 540 East Canfield Street, Detroit, MI 48201, USA
| | - Lonni Schultz
- Department of Biostatistics, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA
| | - Peggy Auinger
- The Department of Neurology, Center for Human Experimental Therapeutics, University of Rochester School of Medicine and Dentistry, 1351 Mount Hope Avenue, Rochester, NY 14620, USA
| | - Mei Lu
- Department of Biostatistics, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA
| |
Collapse
|
24
|
Berg D, Steinberger JD, Warren Olanow C, Naidich TP, Yousry TA. Milestones in magnetic resonance imaging and transcranial sonography of movement disorders. Mov Disord 2011; 26:979-92. [DOI: 10.1002/mds.23766] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
|
25
|
Krogias C, Strassburger K, Eyding J, Gold R, Norra C, Juckel G, Saft C, Ninphius D. Depression in patients with Huntington disease correlates with alterations of the brain stem raphe depicted by transcranial sonography. J Psychiatry Neurosci 2011; 36:187-94. [PMID: 21138658 PMCID: PMC3080514 DOI: 10.1503/jpn.100067] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Transcranial sonography (TCS) has become a new diagnostic tool in the evaluation of extrapyramidal disorders. Studies of TCS report alterations of the mesencephalic raphe in patients with depression. The aim of this study was to evaluate TCS findings in patients with Huntington disease in correlation with their neurologic and psychiatric status. METHODS We recruited patients with genetically confirmed Huntington disease. The neurological and psychiatric status of participants was assessed by independent physicians. Echogenicities were investigated according to examination protocol for extrapyramidal disorders using a Siemens Sonoline Elegra system. The sonography examiner was blinded for clinical data. RESULTS We included 39 patients in our study; 21 patients (53.8%) showed symptoms of depression at the time of evaluation and, of those, 15 (71.4%) had hypoechogenic raphe structures. Thirty patients (76.9%) had a history of depressive episodes, 19 (63.3%) of them with hypoechogenic raphe structures. All 9 patients without a history of depressive episodes showed normal echogenicity of raphe structures (sensitivity 63.3%, specificity 100%). Twelve (70.6%) of the 17 patients with Huntington disease who showed psychiatric disturbances prior to the occurrence of motor symptoms exhibited pathological raphe echogenicity (sensitivity 70.6%, specificity 68.2%). LIMITATIONS Most of the patients were taking antichoreatic medication, which particularly influences neurologic status. Thus, a meaningful interpretation of the correlation between TCS findings and neurologic features was limited. CONCLUSION As a novel finding, a relation between mesencephalic raphe echogenicity and depressive state could be identified in patients with Huntington disease. An alteration of the serotonergic brain stem raphe might be involved in the pathogenesis of depression in these patients.
Collapse
Affiliation(s)
- Christos Krogias
- Department of Neurology, St. Josef-Hospital, Ruhr University, Bochum, Germany.
| | | | | | | | | | | | | | | |
Collapse
|
26
|
Transcranial sonography for the discrimination of idiopathic Parkinson's disease from the atypical parkinsonian syndromes. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2011. [PMID: 20692498 DOI: 10.1016/s0074-7742(10)90009-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
We reviewed eight studies on transcranial sonography (TCS) as a tool for differentiating idiopathic Parkinson's disease (IPD) from atypical parkinsonian syndromes (APS) and included some first data on TCS findings in the subforms of PSP. Changes of specific structures on TCS like the substantia nigra (SN), lenticular nucleus (LN), and the third ventricle are discussed as well as how they can contribute to differentiate between IPD, multiple system atrophy (MSA), progressive supranuclear palsy (PSP), Lewy body disease (LBD), and corticobasal degeneration (CBD). We finish with an algorithm that may be used to employ TCS as a diagnostic instrument delineating IPD from the APS and discerning among the APS themselves. As TCS is at present the most promising tool for this particular diagnostic problem, this algorithm might be a suitable hypothesis to study in future research.
Collapse
|
27
|
Brüggemann N, Wuerfel J, Petersen D, Klein C, Hagenah J, Schneider SA. Idiopathic NBIA - clinical spectrum and transcranial sonography findings. Eur J Neurol 2011; 18:e58-9. [DOI: 10.1111/j.1468-1331.2010.03298.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
28
|
Substantia nigra hyperechogenicity is a risk marker of Parkinson’s disease: yes. J Neural Transm (Vienna) 2011; 118:613-9. [DOI: 10.1007/s00702-010-0565-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Accepted: 12/12/2010] [Indexed: 11/26/2022]
|
29
|
Berg D. Hyperechogenicity of the substantia nigra: pitfalls in assessment and specificity for Parkinson’s disease. J Neural Transm (Vienna) 2010; 118:453-61. [DOI: 10.1007/s00702-010-0469-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Accepted: 08/16/2010] [Indexed: 10/19/2022]
|
30
|
Hagenah J, Seidel G. Parenchym-Ultraschall bei Parkinson-Syndromen. DER NERVENARZT 2010; 81:1189-95. [DOI: 10.1007/s00115-010-3025-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
31
|
Vernon AC, Ballard C, Modo M. Neuroimaging for Lewy body disease: is the in vivo molecular imaging of α-synuclein neuropathology required and feasible? ACTA ACUST UNITED AC 2010; 65:28-55. [PMID: 20685363 DOI: 10.1016/j.brainresrev.2010.05.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2009] [Revised: 05/26/2010] [Accepted: 05/26/2010] [Indexed: 12/21/2022]
Abstract
Alpha-synuclein aggregation is a neuropathological hallmark of many neurodegenerative diseases including Parkinson's disease (PD), Parkinson's disease with dementia (PDD) and dementia with Lewy bodies (DLB), collectively termed the α-synucleinopathies. Substantial advances in clinical criteria and neuroimaging technology over the last 20 years have allowed great strides in the detection and differential diagnosis of these disorders. Nevertheless, it is clear that whilst the array of different imaging modalities in clinical use allow for a robust diagnosis of α-synucleinopathy in comparison to healthy subjects, there is no clear diagnostic imaging marker that affords a reliable differential diagnosis between the different forms of Lewy body disease (LBD) or that could facilitate tracking of disease progression. This has led to a call for a biomarker based on the pathological hallmarks of these diseases, namely α-synuclein-positive Lewy bodies (LBs). This potentially may be advantageous in terms of early disease detection, but may also be leveraged into a potential marker of disease progression. We here aim to firstly review the current status of neuroimaging biomarkers in PD and related synucleinopathies. Secondly, we outline the rationale behind α-synuclein imaging as a potential novel biomarker as well as the potential benefits and limitations of this approach. Thirdly, we attempt to illustrate the likely technical hurdles to be overcome to permit successful in vivo imaging of α-synuclein pathology in the diseased brain. Our overriding aim is to provide a framework for discussion of how to address this major unmet clinical need.
Collapse
Affiliation(s)
- Anthony C Vernon
- Kings College London, Institute of Psychiatry, Department of Neuroscience, Denmark Hill campus, London, UK
| | | | | |
Collapse
|
32
|
Pathophysiology of Transcranial Sonography Signal Changes in the Human Substantia Nigra. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2010. [DOI: 10.1016/s0074-7742(10)90008-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register]
|