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Walter U, Loewenbrück KF, Dodel R, Storch A, Trenkwalder C, Höglinger G. Systematic review-based guideline "Parkinson's disease" of the German Society of Neurology: diagnostic use of transcranial sonography. J Neurol 2024:10.1007/s00415-024-12502-1. [PMID: 38963440 DOI: 10.1007/s00415-024-12502-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 06/04/2024] [Accepted: 06/07/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND AND OBJECTIVE Transcranial brain parenchyma sonography (TCS) has been recommended as a tool for the early and differential diagnosis of Parkinson's disease (PD) in German and European clinical guidelines. Still, the brain structures to be examined for the diagnostic questions and the requirements for being a qualified investigator were not specified in detail. These issues have now been addressed in the 2023 update of the clinical guideline on PD by the German Society of Neurology (DGN). METHODS The recommendations were based on a systematic literature review following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RESULTS Three diagnostic questions were defined: (1) What is the accuracy of TCS in the differential diagnosis of PD versus atypical and secondary Parkinsonian syndromes? (2) What is the accuracy of TCS in the differential diagnosis of PD versus essential tremor? (3) What is the accuracy of TCS in the diagnosis of PD in persons with typical early symptoms, compared with the diagnosis established by clinical follow-up? The brain structures to be assessed and the level of recommendation were formulated for these questions. The training requirements for being regarded as qualified TCS investigator were stipulated by the responsible medical societies (German Society of Ultrasound in Medicine, DEGUM; German Society for Clinical Neurophysiology and Functional Imaging, DGKN). Finally, the recommendations for these diagnostic questions reached strong consensus (each ≥ 97%) of the guideline committee. Here, the details of review and recommendations are presented. CONCLUSION The updated guideline clarifies the diagnostic uses and limitations of TCS in PD.
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Affiliation(s)
- Uwe Walter
- Department of Neurology, Rostock University Medical Center, Gehlsheimer Str. 20, 18147, Rostock, Germany.
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE) Rostock/Greifswald, Rostock, Germany.
- Center for Transdisciplinary Neurosciences Rostock (CTNR), Rostock, Germany.
| | - Kai F Loewenbrück
- Faculty of Medicine Carl Gustav Carus, Department of Neurology, University Hospital, Technische Universität Dresden, Dresden, Germany
- Service de Neurologie, Centre Hospitalier de Luxembourg, Luxembourg, Grand Duchy of Luxembourg
| | - Richard Dodel
- Chair of Geriatric Medicine and Center for Translational Neuro- and Behavioral Sciences, University Duisburg-Essen, Essen, Germany
| | - Alexander Storch
- Department of Neurology, Rostock University Medical Center, Gehlsheimer Str. 20, 18147, Rostock, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE) Rostock/Greifswald, Rostock, Germany
- Center for Transdisciplinary Neurosciences Rostock (CTNR), Rostock, Germany
| | - Claudia Trenkwalder
- Paracelsus-Elena-Klinik, Kassel, Germany
- Department of Neurosurgery, University Medical Center Göttingen, Göttingen, Germany
| | - Günter Höglinger
- Department of Neurology, LMU University Hospital, Ludwig-Maximilians-Universität (LMU) München, Munich, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
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Zhu S, Shi Y, Chen Z, Long Z, Wan L, Chen D, Yuan X, Fu Y, Deng F, Long X, Du K, Qiu R, Tang B, Wang C, Jiang H. The characteristic and biomarker value of transcranial sonography in cerebellar ataxia. Ann Clin Transl Neurol 2024. [PMID: 38924300 DOI: 10.1002/acn3.52131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 05/18/2024] [Accepted: 05/24/2024] [Indexed: 06/28/2024] Open
Abstract
OBJECTIVE Transcranial sonography (TCS) is a noninvasive neuroimaging technique, visualizing deep brain structures and the ventricular system. Although widely employed in diagnosing various movement disorders, such as Parkinson's disease and dystonia, by detecting disease-specific abnormalities, the specific characteristics of the TCS in cerebellar ataxia remain inconclusive. We aimed to assess the potential value of TCS in patients with cerebellar ataxias for disease diagnosis and severity assessment. METHODS TCS on patients with genetic and acquired cerebellar ataxia, including 94 with spinocerebellar ataxias (SCAs) containing 10 asymptomatic carriers, 95 with cerebellar subtype of multiple system atrophy (MSA-C), and 100 healthy controls (HC), was conducted. Assessments included third ventricle width, substantia nigra (SN) and lentiform nucleus (LN) echogenicity, along with comprehensive clinical evaluations and genetic testing. RESULTS The study revealed significant TCS abnormalities in patients with cerebellar ataxia, such as enlarged third ventricle widths and elevated rates of hyperechogenic SN and LN. TCS showed high accuracy in distinguishing patients with SCA or MSA-C from HC, with an AUC of 0.870 and 0.931, respectively. TCS abnormalities aided in identifying asymptomatic SCA carriers, effectively differentiating them from HC, with an AUC of 0.725. Furthermore, third ventricle width was significantly correlated with SARA and ICARS scores in patients with SCA3 and SCOPA-AUT scores in patients with MSA-C. The SN area and SARA or ICARS scores in patients with SCA3 were also positively correlated. INTERPRETATION Our findings illustrate remarkable TCS abnormalities in patients with cerebellar ataxia, serving as potential biomarkers for clinical diagnosis and progression assessment.
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Affiliation(s)
- Sudan Zhu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Yuting Shi
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
| | - Zhao Chen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
| | - Zhe Long
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China
- Clinical Medical Research Center for Stroke Prevention and Treatment of Hunan Province, Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Linlin Wan
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, China
- National International Collaborative Research Center for Medical Metabolomics, Central South University, Changsha, China
| | - Daji Chen
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Xinrong Yuan
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - You Fu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Feiyan Deng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Xiafei Long
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Kefang Du
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
| | - Rong Qiu
- School of Computer Science and Engineering, Central South University, Changsha, China
| | - Beisha Tang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
| | - Chunrong Wang
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, China
| | - Hong Jiang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Hunan Province in Neurodegenerative Disorders, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
- Hunan International Scientific and Technological Cooperation Base of Neurodegenerative and Neurogenetic Diseases, Changsha, China
- National International Collaborative Research Center for Medical Metabolomics, Central South University, Changsha, China
- Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, China
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Walter U, Buchmann J, Sülldorf A, Dück A, Russnak A, Hässler F, Berger C. Transcranial sonography of subcortical structures in tic/tourette disorder. J Psychiatr Res 2024; 176:18-22. [PMID: 38830296 DOI: 10.1016/j.jpsychires.2024.05.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 05/15/2024] [Accepted: 05/29/2024] [Indexed: 06/05/2024]
Abstract
Functional neuroimaging studies demonstrate disinhibition of the cortico-striatal-thalamo-cortical circuit. However, structural imaging studies revealed conflicting results, some suggesting smaller volumes of the caudate nucleus (CN) in children with Gilles de la Tourette syndrome (TS). Here we wanted to find out whether transcranial sonography (TCS) detects alterations of raphe nuclei, substantia nigra, lenticular nucleus (LN), or CN in children with Tic disorder or TS (TIC/TS).The study included 25 treatment-naive children (age: 12.2 ± 2.5 years) with a DSM-V based diagnosis of Tic disorder or TS (10 subjects), without other psychiatric or neurologic diagnosis, and 25 healthy controls (age: 12.17 ± 2.57 years), matched for age and sex. Parental rating of behavioral, emotional abnormalities, somatic complaints and social competencies of the participants were assessed using the Child Behavior Check List (CBCL/4-18R). TCS of deep brain structures was conducted through the preauricular acoustic bone windows using a 2.5-MHz phased-array ultrasound system. Fisher's exact test and Mann-Whitney-U test were used for comparisons between TIC/TS patients and healthy volunteers. The number of participants with hyperechogenic area of left CN in the TIC/TS sample was increased, compared to the healthy control group. TIC/TS patients with hyperechogenic CN showed an increased occurrence of thought- and obsessive-compulsive problems. This TCS study revealed pathologic structural changes in CN, its higher occurrence in TIC/TS compared to healthy controls and the relation to comorbidity of thought problems. Further research should focus on the molecular cause of these alterations, probably the disturbed iron metabolism.
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Affiliation(s)
- Uwe Walter
- Department of Neurology, Rostock University Medical Center, Rostock, Germany
| | - Johannes Buchmann
- Department of Psychiatry, Neurology, Psychosomatics, and Psychotherapy in Childhood and Adolescence, Rostock University Medical Center, Rostock, Germany
| | - Anne Sülldorf
- Department of Psychiatry, Neurology, Psychosomatics, and Psychotherapy in Childhood and Adolescence, Rostock University Medical Center, Rostock, Germany
| | - Alexander Dück
- Department of Psychiatry, Neurology, Psychosomatics, and Psychotherapy in Childhood and Adolescence, Rostock University Medical Center, Rostock, Germany
| | - Antonia Russnak
- Department of Neurology, Rostock University Medical Center, Rostock, Germany
| | - Frank Hässler
- Department of Psychiatry, Neurology, Psychosomatics, and Psychotherapy in Childhood and Adolescence, Rostock University Medical Center, Rostock, Germany
| | - Christoph Berger
- Department of Psychiatry, Neurology, Psychosomatics, and Psychotherapy in Childhood and Adolescence, Rostock University Medical Center, Rostock, Germany.
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Fan Y, Ma J, Yang D, Li X, Liang K, She Z, Qi X, Shi X, Gu Q, Zheng J, Li D. Clinical findings of hyperechoic substantia nigra in patients with Parkinson's disease. Eur J Neurosci 2024; 59:2702-2714. [PMID: 38469656 DOI: 10.1111/ejn.16308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 01/06/2024] [Accepted: 02/19/2024] [Indexed: 03/13/2024]
Abstract
This study aims to analyse hyperechoic substantia nigra (HSN) characteristics and the correlation of HSN with clinical features and blood biomarkers in patients with Parkinson's disease (PD). Transcranial sonography (TCS) evaluations of the substantia nigra (SN) were performed in 40 healthy controls and 71 patients with PD, including patients with SN hyperechogenicity (SN+) and those with normal SN echogenicity (SN-). Evaluation of motor and non-motor symptoms was assessed by a series of rating scales. The uricase method was used to determine serum uric acid (UA) levels, and enzyme-linked immunosorbent assay (ELISA) was used to measure plasma interleukin (IL)-1β levels. TCS showed 92.50% specificity and 61.97% sensitivity in differentiating PD patients from controls. The area of SN+ contralateral to the side of initial motor symptoms (SNcontra) was larger than that ipsilateral to the side of initial motor symptoms (SNipsi). The PDSN+ group had lower Argentine Hyposmia Rating Scale (AHRS) scores and UA levels than the PDSN- group. Binary logistic regression analysis revealed that AHRS scores and UA levels could be independent predictors for HSN. The larger SN echogenic area (SNL) sizes positively correlated with plasma IL-1β levels in PD patients with SN+. The present study provides further evidence of the potential of SN echogenicity as an imaging biomarker for PD diagnosis. PD patients with HSN have more severe non-motor symptoms of hyposmia. HSN in PD patients is related to the mechanism of abnormal iron metabolism and microglial activation.
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Affiliation(s)
- Yongyan Fan
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Jianjun Ma
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China
| | - Dawei Yang
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Xiaohuan Li
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Keke Liang
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China
| | - Zonghan She
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Xuelin Qi
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
| | - Xiaoxue Shi
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China
| | - Qi Gu
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China
| | - Jinhua Zheng
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China
| | - Dongsheng Li
- Department of Neurology, Zhengzhou University People's Hospital, Zhengzhou, China
- Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China
- Department of Neurology, Henan University People's Hospital, Zhengzhou, China
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Kerscher SR, Zipfel J, Haas-Lude K, Bevot A, Schuhmann MU. Ultrasound-guided initial diagnosis and follow-up of pediatric idiopathic intracranial hypertension. Pediatr Radiol 2024; 54:1001-1011. [PMID: 38506946 PMCID: PMC11111542 DOI: 10.1007/s00247-024-05905-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 03/04/2024] [Accepted: 03/05/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Idiopathic intracranial hypertension in children often presents with non-specific symptoms found in conditions such as hydrocephalus. For definite diagnosis, invasive intracranial pressure measurement is usually required. Ultrasound (US) of the optic nerve sheath diameter provides a non-invasive method to assess intracranial pressure. Transtemporal US allows imaging of the third ventricle and thus assessment for hydrocephalus. OBJECTIVE To investigate whether the combination of US optic nerve sheath and third ventricle diameter can be used as a screening tool in pediatric idiopathic intracranial hypertension to indicate elevated intracranial pressure and exclude hydrocephalus as an underlying pathology. Further, to analyze whether both parameters can be used to monitor treatment outcome. MATERIALS AND METHODS We prospectively included 36 children with idiopathic intracranial hypertension and 32 controls. Using a 12-Mhz linear transducer and a 1-4-Mhz phased-array transducer, respectively, optic nerve sheath and third ventricle diameters were determined initially and during the course of treatment. RESULTS In patients, the mean optic nerve sheath diameter was significantly larger (6.45±0.65 mm, controls: 4.96±0.32 mm) and the mean third ventricle diameter (1.69±0.65 mm, controls: 2.99±1.31 mm) was significantly smaller compared to the control group, P<0.001. Optimal cut-off values were 5.55 mm for the optic nerve sheath and 1.83 mm for the third ventricle diameter. CONCLUSIONS The combined use of US optic nerve sheath and third ventricle diameter is an ideal non-invasive screening tool in pediatric idiopathic intracranial hypertension to indicate elevated intracranial pressure while ruling out hydrocephalus. Treatment can effectively be monitored by repeated US, which also reliably indicates relapse.
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Affiliation(s)
- Susanne Regina Kerscher
- Department of Diagnostic and Interventional Radiology, University Hospital of Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
- Department of Neurosurgery, Division of Pediatric Neurosurgery, University Hospital of Tuebingen, Tuebingen, Germany.
| | - Julian Zipfel
- Department of Neurosurgery, Division of Pediatric Neurosurgery, University Hospital of Tuebingen, Tuebingen, Germany
| | - Karin Haas-Lude
- Department of Pediatric Neurology and Developmental Medicine, University Children's Hospital of Tuebingen, Tuebingen, Germany
| | - Andrea Bevot
- Department of Pediatric Neurology and Developmental Medicine, University Children's Hospital of Tuebingen, Tuebingen, Germany
| | - Martin Ulrich Schuhmann
- Department of Neurosurgery, Division of Pediatric Neurosurgery, University Hospital of Tuebingen, Tuebingen, Germany
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Zhong C, Guo N, Hu C, Ni R, Zhang X, Meng Z, Liu T, Ding S, Ding W, Zhao Y, Cao L, Zheng Y. Efficacy of Wearable low-intensity pulsed Ultrasound treatment in the Movement disorder in Parkinson's disease (the SWUMP trial): protocol for a single-site, double-blind, randomized controlled trial. Trials 2024; 25:275. [PMID: 38650028 PMCID: PMC11036625 DOI: 10.1186/s13063-024-08092-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 04/03/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Parkinson's disease (PD) is a progressive, neurodegenerative illness marked by the loss of dopaminergic neurons, causing motor symptoms. Oral levodopa replacement therapy remains the gold standard in the treatment of PD. It is, nevertheless, a symptomatic treatment. There is currently no effective treatment for PD. Therefore, new therapies for PD are highly desirable. Low-intensity pulsed ultrasound (LIPUS) has been shown to improve behavioral functions in PD animal models. It is a new type of neuromodulation approach that combines noninvasiveness with high spatial precision. The purpose of this study is to establish a new clinical protocol for LIPUS in the treatment of movement disorders in patients with PD. METHODS This protocol is a single-site, prospective, double-blind, randomized controlled trial (RCT). Forty-eight participants with clinically confirmed PD will be randomly allocated to one of two groups: LIPUS group or sham group. All of the participants continue to use pharmacological therapy as a fundamental treatment. The primary outcome is the difference between groups from baseline to 4 months in the change in the Unified Parkinson's Disease Rating Scale (UPDRS) motor score (part III). The secondary outcomes include the rating scales such as the Mini-Mental State Examination (MMSE), and other three rating scales, and medical examinations including high-density electroencephalography (hdEEG) and functional magnetic resonance imaging (fMRI). The primary safety outcome will be assessed at 4 months, and adverse events will be recorded. DISCUSSION This study represents the clinical investigation into the efficacy of therapeutic LIPUS in the treatment of PD for the first time. If LIPUS is determined to be effective, it could offer a practical and innovative means of expanding the accessibility of ultrasound therapy by using a wearable LIPUS device within a home setting. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR2100052093. Registered on 17 October 2021.
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Affiliation(s)
- Chuanyu Zhong
- Department of Ultrasound in Medicine, Shanghai Jiao Tong University of Medicine Affiliated Sixth People's Hospital, Shanghai, 200233, People's Republic of China
| | - Ning Guo
- Department of Ultrasound in Medicine, Shanghai Jiao Tong University of Medicine Affiliated Sixth People's Hospital, Shanghai, 200233, People's Republic of China
| | - Canfang Hu
- Department of Neurology, Shanghai Jiao Tong University of Medicine Affiliated Sixth People's Hospital, Shanghai, 200233, People's Republic of China
- Department of Neurology Medical, Jinshan Branch of Shanghai Sixth People's Hospital, Shanghai, 201599, People's Republic of China
| | - Ruilong Ni
- Department of Neurology, Shanghai Jiao Tong University of Medicine Affiliated Sixth People's Hospital, Shanghai, 200233, People's Republic of China
| | - Xiaojie Zhang
- Department of Neurology, Shanghai Jiao Tong University of Medicine Affiliated Sixth People's Hospital, Shanghai, 200233, People's Republic of China
| | - Zheying Meng
- Department of Ultrasound in Medicine, Shanghai Jiao Tong University of Medicine Affiliated Sixth People's Hospital, Shanghai, 200233, People's Republic of China
| | - Taotao Liu
- Department of Neurology, Shanghai Jiao Tong University of Medicine Affiliated Sixth People's Hospital, Shanghai, 200233, People's Republic of China
| | - Siqi Ding
- Department of Neurology, Shanghai Jiao Tong University of Medicine Affiliated Sixth People's Hospital, Shanghai, 200233, People's Republic of China
| | - Wanhai Ding
- Department of Neurosurgery, Shanghai Jiao Tong University of Medicine Affiliated Sixth People's Hospital, Shanghai, 200233, People's Republic of China
| | - Yuwu Zhao
- Department of Neurology, Shanghai Jiao Tong University of Medicine Affiliated Sixth People's Hospital, Shanghai, 200233, People's Republic of China.
| | - Li Cao
- Department of Neurology, Shanghai Jiao Tong University of Medicine Affiliated Sixth People's Hospital, Shanghai, 200233, People's Republic of China.
| | - Yuanyi Zheng
- Department of Ultrasound in Medicine, Shanghai Jiao Tong University of Medicine Affiliated Sixth People's Hospital, Shanghai, 200233, People's Republic of China.
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Djordjević I, Djordjević S, Kosać A, Vučinić D, Ivanović Radović N, Ždraljević M, Mijajlović M. Transcranial brain parenchyma sonography in patients with juvenile myoclonic epilepsy. Acta Neurol Belg 2024:10.1007/s13760-024-02561-6. [PMID: 38644442 DOI: 10.1007/s13760-024-02561-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 04/15/2024] [Indexed: 04/23/2024]
Abstract
INTRODUCTION There are rising evidences that subcortical structures, including the basal ganglia, are affected in patients with epilepsy. These structures are thought to influence the modulation and phenotypic expression of epileptic seizures. Our study aimed to evaluate the presence of structural abnormalities in subcortical structures in patients with juvenile myoclonic epilepsy (JME). METHODS This cross-sectional study included 51 patients who were diagnosed with JME and who were monitored on an outpatient basis at the Clinic for Neurology and Psychiatry for Children and Youth in Belgrade from January 1985 to October 2017. All patients underwent transcranial parenchymal sonography (TCS) from October 2015 to October 2017. Relation of clinical parameters (seizure control andcognitive functioning,) with TCS results was assessed. RESULTS Hyperechogenicity of the substantia nigra (SN) was detected in 37.2% of JME subjects and it was significantly more common in patients with JME than in the control group. The marked echogenicity of the red nucleus (RN) was detected in 17.6% of cases, while 11.8% of subjects had hyperechogenic RN. The presence of hyperechogenic RN (both right and left) was significantly more frequent in the group of patients with JME compared to the control group. The third ventricle diameter was larger in patients with JME than in controls. CONCLUSION Structural changes of certain subcortical structures, primarily SN and RN, detected in JME patients indicate additional non-lesional abnormalities of the basal ganglia and midbrain structures in these patients.
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Affiliation(s)
- Ivana Djordjević
- Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia
| | - Stefan Djordjević
- University Children's Hospital, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ana Kosać
- Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Dragana Vučinić
- Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia
| | - Nelica Ivanović Radović
- Institute for Children's Diseases, Clinical Center of Montenegro, Podgorica, Montenegro
- Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
| | - Mirjana Ždraljević
- University Clinical Center of Serbia, Neurology Clinic, 6, Dr Subotica Street, 11000, Belgrade, Serbia
| | - Milija Mijajlović
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
- University Clinical Center of Serbia, Neurology Clinic, 6, Dr Subotica Street, 11000, Belgrade, Serbia.
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Mijajlovic M, Bozovic I, Pavlovic A, Rakocevic-Stojanovic V, Gluscevic S, Stojanovic A, Basta I, Meola G, Peric S. Transcranial brain parenchyma sonographic findings in patients with myotonic dystrophy type 1 and 2. Heliyon 2024; 10:e26856. [PMID: 38434309 PMCID: PMC10907768 DOI: 10.1016/j.heliyon.2024.e26856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 02/06/2024] [Accepted: 02/21/2024] [Indexed: 03/05/2024] Open
Abstract
Introduction Myotonic dystrophy type 1 (DM1) and 2 (DM2) are genetically determined progressive muscular disorders with multisystemic affection, including brain involvement. Transcranial sonography (TCS) is a reliable diagnostic tool for the investigation of deep brain structures. We sought to evaluate TCS findings in genetically confirmed DM1 and DM2 patients, and further correlate these results with patients' clinical features. Methods This cross-sectional study included 163 patients (102 DM1, 61 DM2). Echogenicity of the brainstem raphe (BR) and substantia nigra (SN) as well as the diameter of the third ventricle (DTV) were assessed by TCS. Patients were evaluated using the Hamilton Depression Rating Scale, Fatigue Severity Scale and Daytime Sleepiness Scale. Results SN hyperechogenicity was observed in 40% of DM1 and 34% of DM2 patients. SN hypoechogenicity was detected in 17% of DM1 and 7% of DM2 patients. BR hypoechogenicity was found in 36% of DM1 and 47% of DM2 subjects. Enlarged DTV was noted in 19% of DM1 and 15% of DM2 patients. Older, weaker, depressive, and fatigued DM1 patients were more likely to have BR hypoechogenicity (p < 0.05). DTV correlated with age and disease duration in DM1 (p < 0.01). In DM2 patients SN hyperechogenicity correlated with fatigue. Excessive daytime sleepiness was associated with hypoechogenic BR (p < 0.05) and enlarged DVT (p < 0.01) in DM2 patients. Conclusions TCS is an easy applicable and sensitive neuroimaging technique that could offer new information regarding several brainstem structures in DM1 and DM2. This may lead to better understanding of the pathogenesis of the brain involvement in DM with possible clinical implications.
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Affiliation(s)
- Milija Mijajlovic
- Neurology Clinic, University Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ivo Bozovic
- Neurology Clinic, University Clinical Center of Serbia, Belgrade, Serbia
| | - Aleksandra Pavlovic
- Neurology Clinic, University Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Faculty of Special Education and Rehabilitation, University of Belgrade, Belgrade, Serbia
| | - Vidosava Rakocevic-Stojanovic
- Neurology Clinic, University Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Sanja Gluscevic
- Neurology Clinic, Clinical Center of Montenegro, Podgorica, Montenegro
| | | | - Ivana Basta
- Neurology Clinic, University Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Giovanni Meola
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Department of Neurorehabilitation Sciences, Casa Di Cura del Policlinico, Milan, Italy
| | - Stojan Peric
- Neurology Clinic, University Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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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.
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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
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10
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Reese R, Kriesen T, Kersten M, Löhle M, Cantré D, Freiman TM, Storch A, Walter U. Combining ultrasound and microelectrode recordings for postoperative localization of subthalamic electrodes in Parkinson's disease. Clin Neurophysiol 2023; 156:196-206. [PMID: 37972531 DOI: 10.1016/j.clinph.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/10/2023] [Accepted: 11/01/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE To assess transcranial sonography (TCS) as stand-alone tool and in combination with microelectrode recordings (MER) as a method for the postoperative localization of deep brain stimulation (DBS) electrodes in the subthalamic nucleus (STN). METHODS Individual dorsal and ventral boundaries of STN (n = 12) were determined on intraoperative MER. Postoperatively, a standardized TCS protocol was applied to measure medio-lateral, anterior-posterior and rostro-caudal electrode position using visualized reference structures (midline, substantia nigra). TCS and combined TCS-MER data were validated using fusion-imaging and clinical outcome data. RESULTS Test-retest reliability of standard TCS measures of electrode position was excellent. Computed tomography and TCS measures of distance between distal electrode contact and midline agreed well (Pearson correlation; r = 0.86; p < 0.001). Comparing our "gold standard" of rostro-caudal electrode localization relative to STN boundaries, i.e. combining MRI-based stereotaxy and MER data, with the combination of TCS and MER data, the measures differed by 0.32 ± 0.87 (range, -1.35 to 1.25) mm. Combined TCS-MER data identified the clinically preferred electrode contacts for STN-DBS with high accuracy (Coheńs kappa, 0.86). CONCLUSIONS Combined TCS-MER data allow for exact localization of STN-DBS electrodes. SIGNIFICANCE Our method provides a new option for monitoring of STN-DBS electrode location and guidance of DBS programming in Parkinson's disease.
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Affiliation(s)
- René Reese
- Department of Neurology, Rostock University Medical Center, Rostock, Germany.
| | - Thomas Kriesen
- Department of Neurosurgery, Rostock University Medical Center, Rostock, Germany
| | - Maxi Kersten
- Department of Neurology, Rostock University Medical Center, Rostock, Germany; Center for Transdisciplinary Neurosciences Rostock (CTNR), Rostock University Medical Center, Rostock, Germany
| | - Matthias Löhle
- Department of Neurology, Rostock University Medical Center, Rostock, Germany; German Center for Neurodegenerative Diseases (DZNE) Rostock / Greifswald, Rostock, Germany
| | - Daniel Cantré
- Institute of Diagnostic and Interventional Radiology, Pediatric Radiology and Neuroradiology, Rostock University Medical Center, Rostock, Germany
| | - Thomas M Freiman
- Department of Neurosurgery, Rostock University Medical Center, Rostock, Germany
| | - Alexander Storch
- Department of Neurology, Rostock University Medical Center, Rostock, Germany; Center for Transdisciplinary Neurosciences Rostock (CTNR), Rostock University Medical Center, Rostock, Germany; German Center for Neurodegenerative Diseases (DZNE) Rostock / Greifswald, Rostock, Germany
| | - Uwe Walter
- Department of Neurology, Rostock University Medical Center, Rostock, Germany; Center for Transdisciplinary Neurosciences Rostock (CTNR), Rostock University Medical Center, Rostock, Germany; German Center for Neurodegenerative Diseases (DZNE) Rostock / Greifswald, Rostock, Germany.
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11
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Kozel J, Školoudík D, Ressner P, Michalčová P, Dušek P, Hanzlíková P, Dvořáčková N, Heryán T, Bártová P. Echogenicity of Brain Structures in Huntington's Disease Patients Evaluated by Transcranial Sonography - Magnetic Resonance Fusion Imaging using Virtual Navigator and Digital Image Analysis. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2023; 44:495-502. [PMID: 37224875 DOI: 10.1055/a-2081-1635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE Transcranial sonography (TCS) magnetic resonance (MR) fusion imaging and digital image analysis are useful tools for the evaluation of various brain pathologies. This study aimed to compare the echogenicity of predefined brain structures in Huntington's disease (HD) patients and healthy controls by TCS-MR fusion imaging using Virtual Navigator and digitized image analysis. MATERIALS AND METHODS The echogenicity of the caudate nucleus (CN), substantia nigra (SN), lentiform nucleus (LN), insula, and brainstem raphe (BR) evaluated by TCS-MR fusion imaging using digitized image analysis was compared between 21 HD patients and 23 healthy controls. The cutoff values of echogenicity indices for the CN, LN, insula, and BR with optimal sensitivity and specificity were calculated using receiver operating characteristic analysis. RESULTS The mean echogenicity indices for the CN (67.0±22.6 vs. 37.9±7.6, p<0.0001), LN (110.7±23.6 vs. 59.7±11.1, p<0.0001), and insula (121.7±39.1 vs. 70.8±23.0, p<0.0001) were significantly higher in HD patients than in healthy controls. In contrast, BR echogenicity (24.8±5.3 vs. 30.1±5.3, p<0.001) was lower in HD patients than in healthy controls. The area under the curve was 90.9%, 95.5%, 84.1%, and 81.8% for the CN, LN, insula, and BR, respectively. The sensitivity and specificity were 86% and 96%, respectively, for the CN and 90% and 100%, respectively, for the LN. CONCLUSION Increased CN, LN, and insula echogenicity and decreased BR echogenicity are typical findings in HD patients. The high sensitivity and specificity of the CN and LN hyperechogenicity in TCS-MR fusion imaging make them promising diagnostic markers for HD.
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Affiliation(s)
- Jiří Kozel
- Center for Health Research, University of Ostrava Faculty of Medicine, Ostrava, Czech Republic
| | - David Školoudík
- Center for Health Research, University of Ostrava Faculty of Medicine, Ostrava, Czech Republic
| | - Pavel Ressner
- Neurology, Faculty of Medicine, Masaryk University and St. Anne's University Hospital, Brno, Czech Republic
| | - Patricie Michalčová
- Center for Health Research, University of Ostrava Faculty of Medicine, Ostrava, Czech Republic
| | - Petr Dušek
- Neurology, The First Faculty of Medicine, Charles University, Praha, Czech Republic
| | - Pavla Hanzlíková
- Radiodiagnostics, University Hospital Ostrava, Ostrava, Czech Republic
| | - Nina Dvořáčková
- Medical Genetics, University Hospital Ostrava, Ostrava, Czech Republic
| | - Tomáš Heryán
- Center for Health Research, University of Ostrava Faculty of Medicine, Ostrava, Czech Republic
| | - Petra Bártová
- Neurology, University Hospital Ostrava, Ostrava, Czech Republic
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12
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Preston C, Alvarez AM, Allard M, Barragan A, Witte RS. Acoustoelectric Time-Reversal for Ultrasound Phase-Aberration Correction. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2023; 70:854-864. [PMID: 37405897 PMCID: PMC10493188 DOI: 10.1109/tuffc.2023.3292595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Acoustoelectric imaging (AEI) is a technique that combines ultrasound (US) with radio frequency recording to detect and map local current source densities. This study demonstrates a new method called acoustoelectric time reversal (AETR), which uses AEI of a small current source to correct for phase aberrations through a skull or other US-aberrating layers with applications to brain imaging and therapy. Simulations conducted at three different US frequencies (0.5, 1.5, and 2.5 MHz) were performed through media layered with different sound speeds and geometries to induce aberrations of the US beam. Time delays of the acoustoelectric (AE) signal from a monopole within the medium were calculated for each element to enable corrections using AETR. Uncorrected aberrated beam profiles were compared with those after applying AETR corrections, which demonstrated a strong recovery (29%-100%) of lateral resolution and increases in focal pressure up to 283%. To further demonstrate the practical feasibility of AETR, we further conducted bench-top experiments using a 2.5 MHz linear US array to perform AETR through 3-D-printed aberrating objects. These experiments restored lost lateral restoration up to 100% for the different aberrators and increased focal pressure up to 230% after applying AETR corrections. Cumulatively, these results highlight AETR as a powerful tool for correcting focal aberrations in the presence of a local current source with applications to AEI, US imaging, neuromodulation, and therapy.
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13
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Liu QY, Yang M, Sheng YJ, Chen XF, Wang CS, Zhang Y, Mao P, Ding CW, Chen R, Zhang YC, Liu CF. Clinical study of transcranial sonography image characteristics in patients with obstructive sleep apnea. Sleep Breath 2023; 27:1325-1332. [PMID: 36272057 DOI: 10.1007/s11325-022-02729-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 09/29/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE This study aimed to explore the relationship between patients with obstructive sleep apnea (OSA) from subgroups of varying severity and substantia nigra (SN) hyperechogenicity as well as cerebral blood flow detected by transcranial sonography (TCS). The study also explored if there were differences in damage of the SN and in the cerebral blood flow between the bilateral sides. METHODS Right-handed men diagnosed with OSA by polysomnography were recruited from August 2018 to August 2020. The included patients were divided into 3 subgroups (mild, moderate, and severe OSA), and all patients underwent TCS. RESULTS Among the 157 study patients (30 with mild OSA, 25 moderate, and 102 severe), the overall prevalence of SN hyperechogenicity was 15% (23/157). The hyperechogenicity detection rates were 3% (4/157) in the right SN subgroup and 13% (20/157) in the left SN subgroup, which were significantly different. The left side always had reduced blood flow on TCS (P < 0.05). No correlation was observed between the severity of OSA and the detection rates of SN hyperechogenicity (P > 0.05). CONCLUSION Patients with OSA showed a higher detection rate of SN hyperechogenicity on the left compared with the right side. The left middle cerebral arteries had reduced blood flow, which was consistent with the more severe damage of the left SN. No relationship was observed between the severity of OSA and the detection rate of SN hyperechogenicity or hemodynamic parameters.
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Affiliation(s)
- Qing-Yuan Liu
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China
| | - Min Yang
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China
| | - Yu-Jing Sheng
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China
| | - Xiao-Fang Chen
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China
| | - Cai-Shan Wang
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China
| | - Ying Zhang
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China
| | - Pan Mao
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China
| | - Chang-Wei Ding
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China
| | - Rui Chen
- Department of Respiratory Medicine, Sleeping Center, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China.
| | - Ying-Chun Zhang
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, China.
| | - Chun-Feng Liu
- Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China
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Jacob D, Guerrini L, Pescaglia F, Pierucci S, Gelormini C, Minutolo V, Fratini A, Di Lorenzo G, Petersen H, Gargiulo P. Adaptation strategies and neurophysiological response in early-stage Parkinson's disease: BioVRSea approach. Front Hum Neurosci 2023; 17:1197142. [PMID: 37529404 PMCID: PMC10389765 DOI: 10.3389/fnhum.2023.1197142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/28/2023] [Indexed: 08/03/2023] Open
Abstract
Introduction There is accumulating evidence that many pathological conditions affecting human balance are consequence of postural control (PC) failure or overstimulation such as in motion sickness. Our research shows the potential of using the response to a complex postural control task to assess patients with early-stage Parkinson's Disease (PD). Methods We developed a unique measurement model, where the PC task is triggered by a moving platform in a virtual reality environment while simultaneously recording EEG, EMG and CoP signals. This novel paradigm of assessment is called BioVRSea. We studied the interplay between biosignals and their differences in healthy subjects and with early-stage PD. Results Despite the limited number of subjects (29 healthy and nine PD) the results of our work show significant differences in several biosignals features, demonstrating that the combined output of posturography, muscle activation and cortical response is capable of distinguishing healthy from pathological. Discussion The differences measured following the end of the platform movement are remarkable, as the induced sway is different between the two groups and triggers statistically relevant cortical activities in α and θ bands. This is a first important step to develop a multi-metric signature able to quantify PC and distinguish healthy from pathological response.
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Affiliation(s)
- Deborah Jacob
- Institute of Biomedical and Neural Engineering, Reykjavik University, Reykjavik, Iceland
| | - Lorena Guerrini
- Institute of Biomedical and Neural Engineering, Reykjavik University, Reykjavik, Iceland
- Department of Engineering, University of Campania L. Vanvitelli, Aversa, Italy
| | - Federica Pescaglia
- Institute of Biomedical and Neural Engineering, Reykjavik University, Reykjavik, Iceland
- Department of Electrical, Electronic and Information Engineering, University of Bologna, Cesena, Italy
| | - Simona Pierucci
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Carmine Gelormini
- Department of Civil Engineering and Computer Science Engineering, Tor Vergata University of Rome, Rome, Italy
| | - Vincenzo Minutolo
- Department of Engineering, University of Campania L. Vanvitelli, Aversa, Italy
| | - Antonio Fratini
- Engineering for Health Research Centre, Aston University, Birmingham, United Kingdom
| | - Giorgio Di Lorenzo
- Laboratory of Psychophysiology and Cognitive Neuroscience, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Hannes Petersen
- Department of Anatomy, University of Iceland, Reykjavik, Iceland
| | - Paolo Gargiulo
- Institute of Biomedical and Neural Engineering, Reykjavik University, Reykjavik, Iceland
- Department of Science, Landspitali University Hospital, Reykjavik, Iceland
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15
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Kim HG, Jung JH, Moon DC. Effects of Complex Pain Control Programs on Taekwondo Athletes with Recurrent Low Back Pain: A Case Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1271. [PMID: 37512082 PMCID: PMC10384292 DOI: 10.3390/medicina59071271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/18/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023]
Abstract
Background and Objectives: Practitioners of martial arts such as Taekwondo are likelier to experience back pain during training or competition. As the back pain of taekwondo athletes shows various symptoms depending on the athlete's characteristics, such as technique and movement, a case study was conducted to verify the intervention effect suitable for individual traits. We examined the effects of a complex pain control program on pain, mechanosensitivity, and physical function in a Taekwondo athlete with recurrent low back pain (LBP). Materials and Methods: A Taekwondo athlete with LBP was recruited from D University, Busan. The intervention program was performed for 45 min twice a week for 3 weeks, and the patient was followed up with after 2 weeks. The numerical rating pain scale (NRPS), pain pressure threshold, mechanosensitivity, and Oswestry Disability Index (ODI) scores were measured before and after the intervention. Therapeutic massage and nerve stimulation therapy were performed. Lumbar flexion, extension, and rotation were performed in the movement control exercise group, whereas the sliding technique, a neurodynamic technique of the tibial nerve, was applied in the neurodynamic technique group. This effect was verified by comparing the average measured values before and after the intervention. Results: Pain (NRPS) and mechanosensitivity reduced, range of motion and tactile discrimination abilities improved, and physical function (ODI) improved. The effect of the improved intervention lasted 2 weeks. Conclusions: These results indicate that application of complex pain control programs considering the four aspects of pain mechanisms for 3 weeks can be an effective intervention in Taekwondo athletes with recurrent LBP.
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Affiliation(s)
- Hong-Gil Kim
- Department of Physical Therapy, Graduate School, Dong-Eui University, Busan 47340, Republic of Korea
| | - Ju-Hyeon Jung
- Department of Physical Therapy, College of Nursing, Healthcare Sciences and Human Ecology, Dong-Eui University, Busan 47340, Republic of Korea
| | - Dong-Chul Moon
- Department of Physical Therapy, Gimhae College, Gimhae-si 50811, Republic of Korea
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Vilas D, Rubio S, Gea M, Rios J, Ispierto L, Hernández-Pérez M, Paré M, Millán M, Dorado L. Periaqueductal gray matter echogenicity as a marker of migraine chronification: a case control study. J Headache Pain 2023; 24:41. [PMID: 37069501 PMCID: PMC10108492 DOI: 10.1186/s10194-023-01576-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 04/10/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Migraine is one of the most prevalent and disabling medical diseases in the world. The periaqueductal gray matter and the red nucleus play an important role in its pathogenesis. Our aim was to evaluate the echogenicity of the periaqueductal gray matter and the red nucleus in patients with migraine, by means of transcranial ultrasound. METHODS In this cross-sectional study, a group of patients with migraine (according to the International Classification of Headache Disorders) and a group of control subjects with comparable age-and-sex distribution were prospectively included. We evaluated the area and echogenicity of the periaqueductal gray matter and the red nucleus by means of transcranial ultrasound, both bedside and posteriorly analyzed with the medical image viewer Horos. RESULTS We included 115 subjects: 65 patients with migraine (39 of them with chronic migraine and 26 with episodic migraine), and 50 controls. Median disease duration in patients with chronic migraine was 29 (IQR: 19; 40) years, with a median of 18 (IQR: 14; 27) days of migraine per month. The area of the periaqueductal gray matter was larger in patients with chronic migraine compared to episodic migraine and controls (0.15[95%CI 0.12;0.22]cm2; 0.11[95%CI 0.10;0.14]cm2 and 0.12[95%CI 0.09;0.15]cm2, respectively; p = 0.043). Chronic migraine patients showed an intensity of the periaqueductal gray matter echogenicity lower than controls (90.57[95%CI 70.87;117.26] vs 109.56[95%CI 83.30;122.64]; p = 0.035). The coefficient of variation of periaqueductal gray matter echogenicity was the highest in chronic migraine patients (p = 0.009). No differences were observed regarding the area or intensity of red nucleus echogenicity among groups. CONCLUSION Patients with chronic migraine showed a larger area of echogenicity of periaqueductal gray matter, a lower intensity of its echogenicity and a higher heterogenicity within this brainstem structure compared to patients with episodic migraine and controls. The echogenicity of the periaqueductal gray matter should be further investigated as a biomarker of migraine chronification.
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Affiliation(s)
- Dolores Vilas
- Department of Neurosciences, Neurology Service, University Hospital Germans Trias I Pujol, Carretera Canyet s/n, 08916, Badalona, Barcelona, Spain.
| | - Sara Rubio
- Department of Neurosciences, Neurology Service, University Hospital Germans Trias I Pujol, Carretera Canyet s/n, 08916, Badalona, Barcelona, Spain
| | - Mireia Gea
- Institut de Recerca Germans Trias I Pujol (IGTP), Univesitat Autònoma de Barcelona, Badalona, Barcelona, Spain
| | - Jose Rios
- Department of Clinical Farmacology, Hospital Clinic and Medical Statistics Core Facility, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Biostatistics Unit, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lourdes Ispierto
- Department of Neurosciences, Neurology Service, University Hospital Germans Trias I Pujol, Carretera Canyet s/n, 08916, Badalona, Barcelona, Spain
| | - María Hernández-Pérez
- Department of Neurosciences, Neurology Service, University Hospital Germans Trias I Pujol, Carretera Canyet s/n, 08916, Badalona, Barcelona, Spain
| | - Martí Paré
- Department of Neurosciences, Neurology Service, University Hospital Germans Trias I Pujol, Carretera Canyet s/n, 08916, Badalona, Barcelona, Spain
| | - Mònica Millán
- Department of Neurosciences, Neurology Service, University Hospital Germans Trias I Pujol, Carretera Canyet s/n, 08916, Badalona, Barcelona, Spain
| | - Laura Dorado
- Department of Neurosciences, Neurology Service, University Hospital Germans Trias I Pujol, Carretera Canyet s/n, 08916, Badalona, Barcelona, Spain
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Yan JH, Li K, Ge YL, Li W, Wang PZ, Jin H, Zhang JR, Chen J, Wang F, Yang YP, Zhang YC, Li D, Mao CJ, Liu CF. Quantitative Transcranial Sonography Evaluation of Substantia Nigra Hyperechogenicity Is Useful for Predicting Levodopa-Induced Dyskinesia in Parkinson Disease. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:607-615. [PMID: 36456377 DOI: 10.1016/j.ultrasmedbio.2022.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/07/2022] [Accepted: 10/30/2022] [Indexed: 06/17/2023]
Abstract
Levodopa-induced dyskinesia (LID) is a common motor complication in Parkinson disease (PD). Abnormal substantia nigra hyperechogenicity (SN+), detected by transcranial sonography (TCS), plays an important role in the differential diagnosis of PD. The purpose of this study was to investigate the predictive performance of quantitative SN+ evaluations for LID. Five hundred sixty-two individuals were included in our analysis, and 198 individuals were followed up. These individuals were divided into two groups at baseline: the PD with LID (PD+LID) group and the PD without LID (PD-LID) group. The association between total hyperechogenic area of the SN on both sides (SNT) and LID was analyzed by binary logistic analysis. A binary logistic regression model including SNT was applied to establish a model for discriminating LID. At baseline, 105 (18.7%) individuals were diagnosed with LID. The PD+LID group had a longer disease duration, shorter education duration, higher levodopa equivalent doses, greater disease severity and larger SNT. A model combining clinical features and SNT was further established with better efficiency (area under the receiver operating characteristic curve = 0.839). One hundred ninety-eight individuals were followed up; individuals with a larger SNT and a higher predicted probability were more likely to develop LID in our follow-up. Our study determined that quantitative TCS evaluation of SN echogenicity is useful in predicting LID in PD.
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Affiliation(s)
- Jia-Hui Yan
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Kai Li
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Yi-Lun Ge
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Wen Li
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Pu-Zhi Wang
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Hong Jin
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Jin-Ru Zhang
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Jing Chen
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Fen Wang
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University, Suzhou, Jiangsu, China
| | - Ya-Ping Yang
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Ying-Chun Zhang
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Dan Li
- Department of Neurology, Suqian First People's Hospital, Suqian, Jiangsu, China
| | - Cheng-Jie Mao
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China; Department of Neurology, Suqian First People's Hospital, Suqian, Jiangsu, China
| | - Chun-Feng Liu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China; Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of Neuroscience, Soochow University, Suzhou, Jiangsu, China; Department of Neurology, Suqian First People's Hospital, Suqian, Jiangsu, China; Department of Neurology, Second Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
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Chen Z, Zhang W, He W, Guang Y, Yu T, Du Y, Li R. Transcranial sonography with clinical and demographic characteristics to predict cognitive impairment in PD: a longitudinal study. BMC Neurol 2023; 23:15. [PMID: 36639620 PMCID: PMC9837901 DOI: 10.1186/s12883-023-03057-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Parkinson's disease (PD) is a neurodegenerative disease and is clinically characterized by a series of motor symptoms (MS) and nonmotor symptoms (NMS). NMS often appear before MS, while cognitive impairment mostly occurs within a few years after the diagnosis of PD. Therefore, we aimed to predict the risk factors for cognitive impairment (CI) in PD patients based on transcranial sonography, clinical symptoms, and demographic characteristics. METHODS Based on the occurrence time of CI, a total of 172 PD patients were divided into non-CI (N-CI, n = 48), CI at the first treatment (F-CI, n = 58), and CI at the last treatment (L-CI, n = 66) groups. Clinical data (including MS and NMS) and ultrasonic data of all patients at the first treatment and the last treatment were collected retrospectively. Independent samples t tests were used to compare continuous data, and chi-square tests were used to compare categorical data. The risk factors for CI and Parkinson's disease dementia were identified by logistic regression analysis, and an ROC curve was established to explore the diagnostic efficacy. RESULTS 1) The age of onset, first treatment and smoking history of CI patients were significantly different from those of N-CI patients. When age of first treatment ≥61 years was considered the boundary value to diagnose CI, the sensitivity and specificity were 77.40 and 66.70%, respectively. 2) The severity of depression was significantly different between F-CI and N-CI patients at the first treatment, while the cumulative and new or aggravated memory deficit was significantly different between the L-CI and N-CI patients at the last treatment. 3) There was a significant difference in TCS grading between the first and last treatment in L-CI patients. 4) Depression, sexual dysfunction, and olfactory dysfunction in NMS were independent risk factors for CI during the last treatment. 5) The sensitivity and specificity of predicting CI in PD patients were 81.80 and 64.60%, respectively. CONCLUSIONS PD patients with CI were older, and most of them had a history of smoking. Furthermore, there was good diagnostic efficiency for predicting CI in PD via TCS combined with clinical characteristics (especially NMS).
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Affiliation(s)
- Zhiguang Chen
- grid.411617.40000 0004 0642 1244Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050 China
| | - Wei Zhang
- grid.411617.40000 0004 0642 1244Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050 China
| | - Wen He
- grid.411617.40000 0004 0642 1244Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050 China
| | - Yang Guang
- grid.411617.40000 0004 0642 1244Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050 China
| | - Tengfei Yu
- grid.411617.40000 0004 0642 1244Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050 China
| | | | - Rui Li
- grid.411617.40000 0004 0642 1244Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050 China
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19
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Exploratory study to assess feasibility of intracerebral hemorrhage detection by point of care cranial ultrasound. Ultrasound J 2022; 14:40. [PMID: 36251105 PMCID: PMC9576831 DOI: 10.1186/s13089-022-00289-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/14/2022] [Indexed: 11/26/2022] Open
Abstract
Background Limited studies have evaluated the use of ultrasound for detection of intracerebral hemorrhage (ICH) using diagnostic ultrasound Transcranial Doppler machines in adults. The feasibility of ICH detection using Point of care Ultrasound (POCUS) machines has not been explored. We evaluated the feasibility of using cranial POCUS B mode imaging performed using intensive care unit (ICU) POCUS device for ICH detection with a secondary goal of mapping optimal imaging technique and brain topography likely to affect sensitivity and specificity of ICH detection with POCUS. Materials and methods After obtaining IRB approval, a blinded investigator performed cranial ultrasound (Fujifilm, Sonosite® Xporte, transcranial and abdominal presets) through temporal windows on 11 patients with intracerebral pathology within 72 h of last CT/MRI (computed tomography scan/magnetic resonance imaging) brain after being admitted to a neurocritical care unit in Aug 2020 and Nov 2020–Mar 2021. Images were then compared to patient’s CT/MRI to inform topography. Inferential statistics were reported. Results Mean age was 57 (28–77 years) and 6/11 were female. Six patients were diagnosed with ICH, 3 with ischemic stroke, 1 subarachnoid hemorrhage, and 1 brain tumor. The sensitivity and specificity of point of care diagnosis of ICH compared to CT/MRI brain was 100% and 50%, respectively. Mean time between ultrasound scan and CT/MRI was 13.3 h (21 min–39 h). Falx cerebri, choroid calcification and midbrain-related artifacts were the most reproducible hyperechoic signals. Abdominal preset on high gain yielded less artifact than Transcranial Doppler preset for cranial B mode imaging. False positive ICH diagnosis was attributed to intracerebral tumor and midbrain-related artifact. Conclusions Our exploratory analysis yielded preliminary data on use of point of care cranial ultrasound for ICH diagnosis to inform imaging techniques, cranial topography on B mode and sample size estimation for future studies to evaluate sensitivity and specificity of cranial POCUS in adult patients. This pilot study is limited by small sample size and over representation of ICH in the study. Cranial POCUS is feasible using POCUS machines and may have potential as a screening tool if validated in adequately powered studies. Supplementary Information The online version contains supplementary material available at 10.1186/s13089-022-00289-z.
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20
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Brunner C, Schreiber SJ, Bokemeyer M, Ransmayr G, Struhal W, Olbert ED, Alhani N, Vosko MR. Value of ultrasound fusion imaging in detecting vascular cerebral white matter pathology. Ultrasound J 2022; 14:25. [PMID: 35713746 PMCID: PMC9206046 DOI: 10.1186/s13089-022-00275-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Transcranial sonography is beside magnetic resonance imaging (MRI) and computed tomography, a well-established imaging method for evaluation of brain parenchyma and already implicated in various neurological disorders as bed-side investigation possibility in clinical routine. The aim of this study was the qualitative assessment detecting vascular white matter hyperintensities (WMHs), with ultrasound fusion-imaging technique (UFI) and to find the optimal location for their visualization in accordance to the grade of WMHs and to possibly providing a standardized protocol for clinical use. RESULTS 29 patients with WMHs of variable degree quantified according to Fazekas grading scale (n = 13 I; n = 9 II; n = 7 III) and 11 subjects with normal findings on MRI were identified for further analysis. Ultrasound images were analyzed to a standardized protocol and predefined anatomical landmarks. UFI could visualize the MRI-verified WMHs in 147 of 161 localizations (91%). The overall ultrasound detection rate of WMHs increased with higher degree of WMHs burden (I:85%, II:94%, III:97%). The highest sensitivity was achieved at the contralateral central part (CPc) (97%) of the lateral ventricle. The inter-rater analysis between 2 independent raters, who were blinded to the patient's diagnosis and assessed only the B-mode ultrasound images, indicated an 86% agreement with an overall moderate strength of agreement (κ: 0.489, p < 0.0005) for all localizations. The highest accordance within raters was shown at the CPc; 92% (κ: 0.645, p < 0.0005). CONCLUSIONS This explorative study describes prospectively the ultrasound detection of periventricular vascular WMHs based on MRI lesions using UFI. Transcranial ultrasound (TCS) could serve as an additional screening opportunity for the detection of incidental WMLs during routine TCS investigations to initiate early vascular risk factor modification in primary prevention.
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Affiliation(s)
- Cornelia Brunner
- Department of Neurology, Karl Landsteiner University of Health Sciences, University Hospital Tulln, Alter Ziegelweg 10, 3430, Tulln, Austria
- Department of Neurology, Kepler University Hospital, 2, Krankenhausstraße 09, 4020, Linz, Austria
- Department of Neurology, Asklepios Clinic Brandenburg, Anton-Saefkow-Allee 2, 14772, Brandenburg an der Havel, Germany
| | - Stephan Joachim Schreiber
- Department of Neurology, Asklepios Clinic Brandenburg, Anton-Saefkow-Allee 2, 14772, Brandenburg an der Havel, Germany
- Department of Neurology, Oberhavel Kliniken, Clinic Hennigsdorf, Marwitzer Straße 91, 16761, Hennigsdorf, Germany
| | - Martin Bokemeyer
- Department of Neurology, Asklepios Clinic Brandenburg, Anton-Saefkow-Allee 2, 14772, Brandenburg an der Havel, Germany
| | - Gerhard Ransmayr
- Department of Neurology, Kepler University Hospital, 2, Krankenhausstraße 09, 4020, Linz, Austria
| | - Walter Struhal
- Department of Neurology, Karl Landsteiner University of Health Sciences, University Hospital Tulln, Alter Ziegelweg 10, 3430, Tulln, Austria
| | - Elisabeth Daniela Olbert
- Department of Neurology, Karl Landsteiner University of Health Sciences, University Hospital Tulln, Alter Ziegelweg 10, 3430, Tulln, Austria
| | - Naela Alhani
- Department of Neurology, Karl Landsteiner University of Health Sciences, University Hospital Tulln, Alter Ziegelweg 10, 3430, Tulln, Austria
| | - Milan Rastislav Vosko
- Department of Neurology, Kepler University Hospital, 2, Krankenhausstraße 09, 4020, Linz, Austria.
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He L, Wu DF, Zhang JH, Zheng S, Li Y, He W. Factors affecting transtemporal window quality in transcranial sonography. Brain Behav 2022; 12:e2543. [PMID: 35238499 PMCID: PMC9015004 DOI: 10.1002/brb3.2543] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/17/2022] [Accepted: 02/12/2022] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To assess the influencing factors of transtemporal window quality and identify patients suitable for transcranial sonography (TCS) examination in two-dimensional imaging. METHODS In this cross-sectional study, TCS was performed in 161 consecutive patients through the temporal bone window (TBW) in the neurology or neurosurgery department. Each patient's sex, age, height, weight, and temporal bone thickness (TBT) were collected. After examination, the patients were divided into two groups: TBW success and TBW failure. The data were statistically compared between the two groups. RESULTS Among the studied population, the total TBW success rate was 80.1% (95% confidence interval [CI]: 74-86). The TBW success rate was 91.4% (95% CI: 85-98) in males and 70.9% (95% CI: 61-81) in females (p = .001). Sex (p = .001), age (p = .002), height (p = .047), and TBT (p < .001) showed significant differences between the TBW success and failure groups. In males, only TBT (p = .001) showed a significant difference; in females, age (p < .001) and TBT (p = .003) showed a significant difference. The area under the receiver operating characteristic curve (AUC) of sex, age, and TBT and their combination was 0.686, 0.659, 0.842, and 0.922 (p < .001), respectively. The AUC of the combination of parameters was significantly greater than that of age and sex alone (p = .007; p = .0002) but not greater than that of TBT (p = .090). CONCLUSIONS The TBW success rate varied with sex, age, height, and TBT. Males, younger patients, taller patients, and patients with a thinner temporal bone tended to be more suitable for the examination by TCS.
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Affiliation(s)
- Lei He
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Dong-Fang Wu
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jing-Han Zhang
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Shuai Zheng
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yi Li
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wen He
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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22
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Prasuhn J, Strautz R, Lemmer F, Dreischmeier S, Kasten M, Hanssen H, Heldmann M, Brüggemann N. Neuroimaging Correlates of Substantia Nigra Hyperechogenicity in Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2022; 12:1191-1200. [PMID: 35180131 DOI: 10.3233/jpd-213000] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Degeneration of dopaminergic neurons within the brainstem substantia nigra (SN) is both a pathological hallmark of Parkinson's disease (PD) and a major contributor to symptom expression. Therefore, non-invasive evaluation of the SN is critical for diagnosis and evaluation of disease progression. Hyperechogenicity (HE+) on midbrain transcranial sonography (TCS) supports the clinically established diagnosis of PD. Further, postmortem studies suggest involvement of neuromelanin (NM) loss and iron deposition in nigral neurodegeneration and HE+ emergence. However, the associations between HE+ and signs of nigral NM loss and iron deposition revealed by magnetic resonance imaging (MRI) have not been examined. OBJECTIVE To elucidate the magnetic resonance- (MR-) morphological representation of the HE+ by NM-weighted (NMI) and susceptibility-weighted MRI (SWI). METHODS Thirty-four PD patients and 29 healthy controls (HCs) received TCS followed by NMI and SWI. From MR images, two independent raters manually identified the SN, placed seeds in non-SN midbrain areas, and performed semi-automated SN segmentation with different thresholds based on seed mean values and standard deviations. Masks of the SN were then used to extract mean area, mean signal intensity, maximal signal area, maximum signal (for NMI), and minimum signal (for SWI). RESULTS There were no significant differences in NMI- and SWI-based parameters between patients and HCs, and no significant associations between HE+ extent and NMI- or SWI-based parameters. CONCLUSION HE+ on TCS appears unrelated to PD pathology revealed by NMI and SWI. Thus, TCS and MRI parameters should be considered complementary, and the pathophysiological correlates of the HE+ require further study.
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Affiliation(s)
- Jannik Prasuhn
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- Department of Neurology, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
- Center for Brain, Behavior, and Metabolism, University of Lübeck, Lübeck, Germany
| | - Robert Strautz
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- Department of Neurology, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Felicitas Lemmer
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- Department of Neurology, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Shalida Dreischmeier
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- Department of Neurology, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Meike Kasten
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- Center for Brain, Behavior, and Metabolism, University of Lübeck, Lübeck, Germany
- Department of Psychiatry, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Henrike Hanssen
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- Department of Neurology, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
- Center for Brain, Behavior, and Metabolism, University of Lübeck, Lübeck, Germany
| | - Marcus Heldmann
- Department of Neurology, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
- Center for Brain, Behavior, and Metabolism, University of Lübeck, Lübeck, Germany
- Institute of Psychology II, University of Lübeck, Lübeck, Germany
| | - Norbert Brüggemann
- Institute of Neurogenetics, University of Lübeck, Lübeck, Germany
- Department of Neurology, University Medical Center Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
- Center for Brain, Behavior, and Metabolism, University of Lübeck, Lübeck, Germany
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23
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Zhu S, Wang Y, Jiang Y, Gu R, Zhong M, Jiang X, Shen B, Zhu J, Yan J, Pan Y, Zhang L. Clinical Features in Parkinson's Disease Patients with Hyperechogenicity in Substantia Nigra: A Cross-Sectional Study. Neuropsychiatr Dis Treat 2022; 18:1593-1601. [PMID: 35942277 PMCID: PMC9356622 DOI: 10.2147/ndt.s374370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 07/21/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Transcranial ultrasound (TCS) can be used to reveal structural changes in the substantia nigra (SN) and is a potential tool for the early diagnosis of Parkinson's disease (PD). This study aimed to explore the relationship between substantia nigra hyperechogenicity (SNH) and the clinical features of PD patients. METHODS A total of 96 PD patients were included in our study. All patients were detected by TCS and divided into two groups: PD patients with SNH (PDSN+) and those with normal SN echogenicity (PDSN-). The Unified Parkinson's Disease Rating Scale (UPDRS) and the Hoehn & Yahr stage were used to assess the extent of disease-related disability of the PD patients. Non-motor symptoms were evaluated by using several scales. The instrumented stand and walk test was performed on all subjects, and gait data were gathered using a JiBuEn gait analysis system. RESULTS Seventy-five PD patients were successfully assessed by TCS. We found that SNH was associated with a higher UPDRS II scores (p = 0.028). In addition, compared with PDSN- group, the PDSN+ group exhibited more severe gait impairment, including increased variability in stride length (p = 0.042), decreased heel strike angle (p = 0.017), decreased range of motion of hip joints (p = 0.031), and a more asymmetrical walking pattern (p = 0.028). CONCLUSION Our study demonstrated that SNH significantly correlated with activities of daily living and gait impairment in Chinese patients with PD, suggesting the formation of SNH might be a dynamic biomarker reflecting disease severity.
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Affiliation(s)
- Sha Zhu
- Department of Geriatric Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Yaxi Wang
- Department of Geriatric Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Yinyin Jiang
- Department of Geriatric Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Ruxin Gu
- Department of Geriatric Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Min Zhong
- Department of Geriatric Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Xu Jiang
- Department of Geriatric Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Bo Shen
- Department of Geriatric Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Jun Zhu
- Department of Geriatric Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Jun Yan
- Department of Geriatric Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Yang Pan
- Department of Geriatric Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Li Zhang
- Department of Geriatric Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China
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24
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"Parkinson's disease" on the way to progressive supranuclear palsy: a review on PSP-parkinsonism. Neurol Sci 2021; 42:4927-4936. [PMID: 34532773 DOI: 10.1007/s10072-021-05601-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 09/06/2021] [Indexed: 12/12/2022]
Abstract
Progressive supranuclear palsy (PSP) is a progressive atypical parkinsonian syndrome characterised by postural instability, supranuclear ophthalmoplegia, dysarthria, dysphagia, executive dysfunction and other features. This clinical presentation represents the classic PSP-Richardson syndrome (PSP-RS). However, several other clinical subtypes have been recognised, including PSP-parkinsonism (PSP-P), probably the second most common PSP variant. Unlike PSP-RS, PSP-P often presents with an asymmetric onset, tremor and a moderate initial response to levodopa, especially during the first years of the disease, thus resembling Parkinson's disease (PD). It runs a more favourable course, but over time, PSP-P may evolve clinically into PSP-RS. Therefore, it may seem that PSP-P stands clinically between PD and PSP. There are several peculiarities that can distinguish PSP-P from these entities. As there is lack of systematic reviews on PSP-P in the literature, we decided to summarise all the necessary data about the epidemiology, clinical picture, neuroimaging, genetics and other aspects of this PSP variant in order to provide complete information for the reader.
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25
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Moreno-Gambín MI, Tembl JI, Mazón M, Cañada-Martínez AJ, Martí-Bonmatí L, Sevilla T, Vázquez-Costa JF. Role of the nigrosome 1 absence as a biomarker in amyotrophic lateral sclerosis. J Neurol 2021; 269:1631-1640. [PMID: 34379200 PMCID: PMC8857168 DOI: 10.1007/s00415-021-10729-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/19/2021] [Accepted: 07/26/2021] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The absence of nigrosome 1 on brain MRI and the hyperechogenicity of substantia nigra (SNh) by transcranial sonography are two useful biomarkers in the diagnosis of parkinsonisms. We aimed to evaluate the absence of nigrosome 1 in amyotrophic lateral sclerosis (ALS) and to address its meaning. METHODS 136 ALS patients were recruited, including 16 progressive muscular atrophy (PMA) and 22 primary lateral sclerosis (PLS) patients. The SNh area was measured planimetrically by standard protocols. The nigrosome 1 status was qualitatively assessed by two blind evaluators in susceptibility weight images of 3T MRI. Demographic and clinical data were collected and the C9ORF72 expansion was tested in all patients. RESULTS Nigrosome 1 was absent in 30% of ALS patients (36% of PLS, 29% of classical ALS and 19% of PMA patients). There was no relationship between radiological and clinical laterality, nor between nigrosome 1 and SNh area. Male sex (OR = 3.63 [1.51, 9.38], p = 0.005) and a higher upper motor neuron (UMN) score (OR = 1.10 [1.02, 1.2], p = 0.022) were independently associated to nigrosome 1 absence, which also was an independent marker of poor survival (HR = 1.79 [1.3, 2.8], p = 0.013). CONCLUSION In ALS patients, the absence of nigrosome 1 is associated with male sex, UMN impairment and shorter survival. This suggests that constitutional factors and the degree of pyramidal involvement are related to the substantia nigra involvement in ALS. Thus, nigrosome 1 could be a marker of a multisystem degeneration, which in turn associates to poor prognosis.
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Affiliation(s)
- María Isabel Moreno-Gambín
- Neurosonology Laboratory, Department of Neurology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - José I Tembl
- Neurosonology Laboratory, Department of Neurology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Miguel Mazón
- Radiology and Biomedical Imaging Research Group (GIBI230), Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - Luis Martí-Bonmatí
- Radiology and Biomedical Imaging Research Group (GIBI230), Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Teresa Sevilla
- ALS Unit, Department of Neurology, Hospital Universitario y Politécnico La Fe, Valencia, Spain.,Neuromuscular Research Unit, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Valencia, Spain.,Department of Medicine, University of Valencia, Valencia, Spain
| | - Juan F Vázquez-Costa
- ALS Unit, Department of Neurology, Hospital Universitario y Politécnico La Fe, Valencia, Spain. .,Neuromuscular Research Unit, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain. .,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Valencia, Spain. .,Department of Medicine, University of Valencia, Valencia, Spain.
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26
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Wu J, Jin H, Shao Y, Mao C, Chen J, Liu C. Cognition and transcranial sonography in Parkinson's disease patients with or without orthostatic hypotension. Brain Behav 2021; 11:e2252. [PMID: 34291604 PMCID: PMC8413744 DOI: 10.1002/brb3.2252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 04/26/2021] [Accepted: 06/01/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Orthostatic hypotension (OH) is a common nonmotor symptom in patients with Parkinson's disease (PD), with an incidence ranging from 14% to 54%. AIMS This study explored changes in cognition and transcranial sonography (TCS) findings in patients with PD and OH. METHODS We enrolled PD patients who visited the outpatient or inpatient department from 2017 to 2020. Blood pressure was measured in different positions, and demographic data were collected. Motor and nonmotor symptoms were evaluated using standard scales. A subset of 107 patients underwent TCS. RESULTS We enrolled 66 PD-OH patients and 92 PD-no orthostatic hypotension (NOH) patients. There were no significant differences in gender, age, disease duration, or Hoehn and Yahr stage between groups. Binary logistic regression revealed age as an independent risk factor for OH in PD patients. There were statistically significant group differences in visuospatial and executive function and Unified Parkinson's Disease Rating Scale (UPDRS) I and II scores (p < .05). Among PD-OH patients, there was a statistically significant difference in UPDRS II and III scores between patients with or without clinical symptoms (p < .05). The substantia nigra (SN) area was significantly larger in PD-NOH patients (0.45 ± 0.18 cm2 ) than PD-OH patients (0.34 ± 0.16 cm2 ) (p < .05). CONCLUSIONS PD-OH patients had poorer visuospatial and executive function and lower UPDRS I and II scores compared with PD-NOH patients. Within the PD-OH group, there was no significant difference in cognition between patients with or without clinical symptoms. The difference in the SN area may indicate different subtypes of PD or a tendency to develop parkinsonism syndrome.
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Affiliation(s)
- Jia‐jing Wu
- Department of NeurologyThe Second Affiliated Hospital of Soochow UniversitySuzhouChina
| | - Hong Jin
- Department of NeurologyThe Second Affiliated Hospital of Soochow UniversitySuzhouChina
| | - Ying‐qi Shao
- Department of NeurologyThe Second Affiliated Hospital of Soochow UniversitySuzhouChina
| | - Cheng‐jie Mao
- Department of NeurologyThe Second Affiliated Hospital of Soochow UniversitySuzhouChina
| | - Jing Chen
- Department of NeurologyThe Second Affiliated Hospital of Soochow UniversitySuzhouChina
- Department of NeurologySuqian First HospitalSuqianChina
| | - Chun‐feng Liu
- Department of NeurologyThe Second Affiliated Hospital of Soochow UniversitySuzhouChina
- Department of NeurologySuqian First HospitalSuqianChina
- Jiangsu Key Laboratory of Neuropsychiatric Diseases and Institute of NeuroscienceSoochow UniversitySuzhouChina
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Transcranial sonography in differential diagnosis of Parkinson disease and other movement disorders. Chin Med J (Engl) 2021; 134:1726-1731. [PMID: 34238849 PMCID: PMC8318650 DOI: 10.1097/cm9.0000000000001503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background: Reports evaluating the efficacy of transcranial sonography (TCS) for the differential diagnosis of Parkinson disease (PD) and other movement disorders in China are scarce. Therefore, this study aimed to assess the application of TCS for the differential diagnosis of PD, multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and essential tremor (ET) in Chinese individuals. Methods: From 2017 to 2019, 500 inpatients treated at the Department of Dyskinesia, Beijing Tiantan Hospital, Capital Medical University underwent routine transcranial ultrasound examination. The cross-sections at the midbrain and thalamus levels were scanned, and the incidence rates of substantia nigra (SN) positivity and the incidence rates of lenticular hyperechoic area were recorded. The echo of the SN was manually measured. Results: Of the 500 patients, 125 were excluded due to poor signal in temporal window sound transmission. Among the 375 individuals with good temporal window sound transmission, 200 were diagnosed with PD, 90 with ET, 50 with MSA, and 35 with PSP. The incidence rates of SN positivity differed significantly among the four patient groups (χ2 = 121.061, P < 0.001). Between-group comparisons were performed, and the PD group showed a higher SN positivity rate than the ET (χ2 = 94.898, P < 0.017), MSA (χ2 = 57.619, P < 0.017), and PSP (χ2 = 37.687, P < 0.017) groups. SN positivity showed a good diagnostic value for differentiating PD from the other three movement diseases, collectively or individually. The incidences of lenticular hyperechoic area significantly differed among the four patient groups (χ2 = 38.904, P < 0.001). Next, between-group comparisons were performed. The lenticular hyperechoic area was higher in the PD group than in the ET (χ2 = 6.714, P < 0.017) and MSA (χ2 = 18.680, P < 0.017) groups but lower than that in the PSP group (χ2 = 0.679, P > 0.017). Conclusion: SN positivity could effectively differentiate PD from ET, PSP, and MSA in a Chinese population.
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Godani M, Lanza G, Trevisan L, Ferri R, Bella R. An unusual gait disorder at the Emergency Department: role of the quantitative assessment of parenchymal transcranial Doppler sonography. Quant Imaging Med Surg 2021. [PMID: 33936999 DOI: 10.21037/qims-20-982.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | - Giuseppe Lanza
- Department of Surgery and Medical-Surgical Specialties, University of Catania, Italy.,Oasi Research Institute-IRCCS, Troina, Italy
| | - Lucia Trevisan
- Medical Genetic Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Rita Bella
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Italy
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29
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Godani M, Lanza G, Trevisan L, Ferri R, Bella R. An unusual gait disorder at the Emergency Department: role of the quantitative assessment of parenchymal transcranial Doppler sonography. Quant Imaging Med Surg 2021; 11:2195-2200. [PMID: 33936999 PMCID: PMC8047368 DOI: 10.21037/qims-20-982] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
| | - Giuseppe Lanza
- Department of Surgery and Medical-Surgical Specialties, University of Catania, Italy
- Oasi Research Institute–IRCCS, Troina, Italy
| | - Lucia Trevisan
- Medical Genetic Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | | | - Rita Bella
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Italy
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30
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Emsell L, Laroy M, Van Cauwenberge M, Vande Casteele T, Vansteelandt K, Van Laere K, Sunaert S, Van den Stock J, Bouckaert F, Vandenbulcke M. The Leuven late life depression (L3D) study: PET-MRI biomarkers of pathological brain ageing in late-life depression: study protocol. BMC Psychiatry 2021; 21:64. [PMID: 33509135 PMCID: PMC7845114 DOI: 10.1186/s12888-021-03063-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 01/19/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Major depressive disorders rank in the top ten causes of ill health in all but four countries worldwide and are the leading cause of years lived with disability in Europe (WHO). Recent research suggests that neurodegenerative pathology may contribute to the development of late-life depression (LLD) in a sub-group of patients and represent a target for prevention and early diagnosis. In parallel, electroconvulsive therapy (ECT), which is the most effective treatment for severe LLD, has been associated with significant brain structural changes. In both LLD and ECT hippocampal volume change plays a central role; however, the neurobiological mechanism underlying it and its relevance for clinical outcomes remain unresolved. METHODS This is a monocentric, clinical cohort study with a cross-sectional arm evaluating PET-MR imaging and behavioural measures in 64 patients with LLD compared to 64 healthy controls, and a longitudinal arm evaluating the same imaging and behavioural measures after 10 ECT sessions in 20 patients receiving ECT as part of their normal clinical management. Triple tracer PET-MRI data will be used to measure: hippocampal volume (high resolution MRI), synaptic density using [11C]UCB-J, which targets the Synaptic Vesicle Glycoprotein 2A receptor, tau pathology using [18F]MK-6240, and cerebral amyloid using [18F]-Flutemetamol, which targets beta-amyloid neuritic plaques in the brain. Additional MRI measures and ultrasound will assess cerebral vascular structure and brain connectivity. Formal clinical and neuropsychological assessments will be conducted alongside experience sampling and physiological monitoring to assess mood, stress, cognition and psychomotor function. DISCUSSION The main aim of the study is to identify the origin and consequences of hippocampal volume differences in LLD by investigating how biomarkers of pathological ageing contribute to medial temporal lobe pathology. Studying how synaptic density, tau, amyloid and vascular pathology relate to neuropsychological, psychomotor function, stress and ECT, will increase our pathophysiological understanding of the in vivo molecular, structural and functional alterations occurring in depression and what effect this has on clinical outcome. It may also lead to improvements in the differential diagnosis of depression and dementia yielding earlier, more optimal, cost-effective clinical management. Finally, it will improve our understanding of the neurobiological mechanism of ECT. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03849417 , 21/2/2019.
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Affiliation(s)
- Louise Emsell
- Geriatric Psychiatry, University Psychiatric Center KU Leuven, B-3000, Leuven, Belgium.
- KU Leuven, Leuven Brain Institute, Department of Neurosciences, Neuropsychiatry, B-3000, Leuven, Belgium.
- KU Leuven, Department of Imaging & Pathology, Translational MRI, B-3000, Leuven, Belgium.
| | - Maarten Laroy
- KU Leuven, Leuven Brain Institute, Department of Neurosciences, Neuropsychiatry, B-3000, Leuven, Belgium
| | - Margot Van Cauwenberge
- KU Leuven, Leuven Brain Institute, Department of Neurosciences, Neuropsychiatry, B-3000, Leuven, Belgium
- Department of Neurology, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium
| | - Thomas Vande Casteele
- Geriatric Psychiatry, University Psychiatric Center KU Leuven, B-3000, Leuven, Belgium
- KU Leuven, Leuven Brain Institute, Department of Neurosciences, Neuropsychiatry, B-3000, Leuven, Belgium
| | - Kristof Vansteelandt
- Geriatric Psychiatry, University Psychiatric Center KU Leuven, B-3000, Leuven, Belgium
- Academisch Centrum voor ECT en Neuromodulatie (AcCENT), University Psychiatric Center KU Leuven, Kortenberg, Belgium
| | - Koen Van Laere
- Department of Nuclear Medicine and Molecular Imaging, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium
| | - Stefan Sunaert
- KU Leuven, Department of Imaging & Pathology, Translational MRI, B-3000, Leuven, Belgium
- Department of Radiology, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium
| | - Jan Van den Stock
- Geriatric Psychiatry, University Psychiatric Center KU Leuven, B-3000, Leuven, Belgium
- KU Leuven, Leuven Brain Institute, Department of Neurosciences, Neuropsychiatry, B-3000, Leuven, Belgium
| | - Filip Bouckaert
- Geriatric Psychiatry, University Psychiatric Center KU Leuven, B-3000, Leuven, Belgium
- KU Leuven, Leuven Brain Institute, Department of Neurosciences, Neuropsychiatry, B-3000, Leuven, Belgium
- Department of Nuclear Medicine and Molecular Imaging, University Hospitals Leuven, Herestraat 49, B-3000, Leuven, Belgium
| | - Mathieu Vandenbulcke
- Geriatric Psychiatry, University Psychiatric Center KU Leuven, B-3000, Leuven, Belgium
- KU Leuven, Leuven Brain Institute, Department of Neurosciences, Neuropsychiatry, B-3000, Leuven, Belgium
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Arasaratnam CJ, Singh-Bains MK, Waldvogel HJ, Faull RLM. Neuroimaging and neuropathology studies of X-linked dystonia parkinsonism. Neurobiol Dis 2020; 148:105186. [PMID: 33227492 DOI: 10.1016/j.nbd.2020.105186] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 11/11/2020] [Accepted: 11/16/2020] [Indexed: 01/17/2023] Open
Abstract
X-linked Dystonia Parkinsonism (XDP) is a recessive, genetically inherited neurodegenerative disorder endemic to Panay Island in the Philippines. Clinical symptoms include the initial appearance of dystonia, followed by parkinsonian traits after 10-15 years. The basal ganglia, particularly the striatum, is an area of focus in XDP neuropathology research, as the striatum shows marked atrophy that correlates with disease progression. Thus, XDP shares features of Parkinson's disease symptomatology, in addition to the genetic predisposition and presence of striatal atrophy resembling Huntington's disease. However, further research is required to reveal the detailed pathology and indicators of disease in the XDP brain. First, there are limited neuropathological studies that have investigated neuronal changes and neuroinflammation in the XDP brain. However, multiple neuroimaging studies on XDP patients provide clues to other affected brain regions. Furthermore, molecular pathological studies have elucidated that the main genetic cause of XDP is in the TAF-1 gene, but how this mutation relates to XDP neuropathology still remains to be fully investigated. Hence, we aim to provide an extensive overview of the current literature describing neuropathological changes within the XDP brain, and discuss future research avenues, which will provide a better understanding of XDP neuropathogenesis.
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Affiliation(s)
- Christine J Arasaratnam
- Centre for Brain Research and Department of Anatomy and Medical Imaging, New Zealand; University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Malvindar K Singh-Bains
- Centre for Brain Research and Department of Anatomy and Medical Imaging, New Zealand; University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Henry J Waldvogel
- Centre for Brain Research and Department of Anatomy and Medical Imaging, New Zealand; University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Richard L M Faull
- Centre for Brain Research and Department of Anatomy and Medical Imaging, New Zealand; University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
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32
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Projective parameter transfer based sparse multiple empirical kernel learning Machine for diagnosis of brain disease. Neurocomputing 2020. [DOI: 10.1016/j.neucom.2020.07.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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33
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Diagnostic Ability of Radiofrequency Ultrasound in Parkinson’s Disease Compared to Conventional Transcranial Sonography and Magnetic Resonance Imaging. Diagnostics (Basel) 2020; 10:diagnostics10100778. [PMID: 33023076 PMCID: PMC7601601 DOI: 10.3390/diagnostics10100778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/28/2020] [Accepted: 09/30/2020] [Indexed: 11/17/2022] Open
Abstract
We aimed to estimate tissue displacements’ parameters in midbrain using ultrasound radiofrequency (RF) signals and to compare diagnostic ability of this RF transcranial sonography (TCS)-based dynamic features of disease affected tissues with conventional TCS (cTCS) and magnetic resonance imaging (MRI) while differentiating patients with Parkinson’s disease (PD) from healthy controls (HC). US tissue displacement waveform parametrization by RF TCS for endogenous brain tissue motion, standard neurological examination, cTCS and MRI data collection were performed for 20 PD patients and for 20 age- and sex-matched HC in a prospective manner. Three logistic regression models were constructed, and receiver operating characteristic (ROC) curve analyses were applied. The model constructed of RF TCS-based brain tissue displacement parameters—frequency of high-end spectra peak and root mean square—revealed presumably increased anisotropy in the midbrain and demonstrated rather good diagnostic ability in the PD evaluation, although it was not superior to that of the cTCS or MRI. Future studies are needed in order to establish the true place of RF TCS detected tissue displacement parameters for the evaluation of pathologically affected brain tissue.
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Kerscher SR, Schweizer LL, Haas-Lude K, Bevot A, Schuhmann MU. Changes of third ventricle diameter (TVD) mirror changes of the entire ventricular system at acute shunt failure and after shunt revision in pediatric hydrocephalus. Childs Nerv Syst 2020; 36:2033-2039. [PMID: 32215715 DOI: 10.1007/s00381-020-04570-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 03/06/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE In hydrocephalic children, regular investigations of the ventricles are important for initial diagnosis and after initial treatment. Our recent study showed that changes of the third ventricle diameter (TVD) reliably reflect changes of the entire ventricular system at diagnosis and following initial therapy. This study compares changes of TVD with changes of ventricle indices at acute shunt failure and after shunt revision in hydrocephalic children. METHODS A total of 117 children with hydrocephalus were included in this study. MRI/CT images of 30 children were evaluated at the time of acute shunt dysfunction and after subsequent shunt revision. Measurements included axial TVD and three standard measures of lateral ventricles (Evans index, frontal occipital horn ratio (FOHR), and cella media index (CMI)). In 97 children, correlation between axial and coronal/diagonal TVD was evaluated at the time of initial diagnosis of hydrocephalus. RESULTS At acute shunt dysfunction, the best linear correlation was found between TVD and CMI (r = 0.702, p < 0.01). Changes of TVD correlated very well to changes of FOHR (r = 0.74, p < 0.01) after shunt revision. The correlation between axial and coronal/diagonal TVD was outstanding (r = 0.995, p < 0.01). CONCLUSION TVD showed a significant correlation with all lateral ventricle indices at acute shunt dysfunction and after shunt revision. It is therefore not only an excellent mirror of ventricular changes at initial hydrocephalus diagnosis and therapy, but it can also reliably reflect changes of the ventricular system in relevant clinical situations associated with the lifelong treatment of pediatric hydrocephalus.
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Affiliation(s)
- Susanne R Kerscher
- Pediatric Neurosurgery, Department of Neurosurgery, University Hospital of Tuebingen, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany. .,Department of Neurosurgery, University Hospital of Tuebingen, Tübingen, Germany.
| | - Louise L Schweizer
- Pediatric Neurosurgery, Department of Neurosurgery, University Hospital of Tuebingen, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany
| | - Karin Haas-Lude
- Department of Pediatric Neurology and Developmental Medicine, Children's Hospital, University of Tuebingen, Tübingen, Germany
| | - Andrea Bevot
- Department of Pediatric Neurology and Developmental Medicine, Children's Hospital, University of Tuebingen, Tübingen, Germany
| | - Martin U Schuhmann
- Pediatric Neurosurgery, Department of Neurosurgery, University Hospital of Tuebingen, Hoppe-Seyler-Str.3, 72076, Tübingen, Germany.,Department of Neurosurgery, University Hospital of Tuebingen, Tübingen, Germany
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Bei HZ, Chen JP, Mao CJ, Zhang YC, Chen J, Du QQ, Xue F, He PC, Jin H, Wang FY, Liu CF. Echogenicity Changes in Brainstem Raphe Detected by Transcranial Parenchymal Sonography and Clinical Characteristics in Parkinson's Disease. Front Neurol 2020; 11:821. [PMID: 32849249 PMCID: PMC7426486 DOI: 10.3389/fneur.2020.00821] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 06/30/2020] [Indexed: 12/20/2022] Open
Abstract
Background: Decreased brainstem raphe (BR) echogenicity detected by transcranial parenchymal sonography (TCS) is associated with depression in psychiatric and neurologic diseases. However, previous studies focusing on the relationship between motor and non-motor symptoms and echogenicity changes in BR in patients with PD yielded controversial results. Objectives: To investigate the relationship between echogenicity changes in BR detected by TCS and motor and a series of non-motor symptoms in patients with PD. Methods: Consecutive PD patients were recruited from the Second Affiliated Hospital of Soochow University. Demographic information and Motor and non-motor symptoms for all subjects were collected. TCS was used to detect the echogenicity changes in BR in PD patients. Results: One hundred and thirty-five consecutive patients with PD were enrolled in the study. The BR abnormal rate was significantly higher in PD patients with anxiety (p = 0.003) or depression (p = 0.022) than patients without. Spearman correlation analyses showed that Hamilton Rating Scale for Depression(HRSD) (r = 0.274, p = 0.002) and Parkinson's Disease Questionnaire 39-item(PDQ-39) (r = 0.208, p = 0.034) scores were positively correlated with abnormal BR echogenicity. Multivariate logistic regression analyses showed that HRSD and HAMA scores were associated with BR hypoechogenicity, the corresponding odds ratios (confidence intervals) were 1.07 (95% CI, 1.01–1.13) and 1.10(1.01–1.18), respectively. However, the PDQ-39 score was not associated with BR hypoechogenicity. Conclusion: The abnormal reduction in BR echogenicity detected by TCS is associated with depression and anxiety, but not motor symptoms in PD patients.
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Affiliation(s)
- Hong-Zhe Bei
- Department of Neurology, The Third Affiliated Hospital of Inner Mongolia Medical University, Baotou, China.,Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Ju-Ping Chen
- Department of Neurology, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu, China
| | - Cheng-Jie Mao
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, The Second Affiliated Hospital of Soochow University, Suzhou, China.,Institutes of Neuroscience, Soochow University, Suzhou, China
| | - Ying-Chun Zhang
- Department of Ultrasound, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jing Chen
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, The Second Affiliated Hospital of Soochow University, Suzhou, China.,Institutes of Neuroscience, Soochow University, Suzhou, China
| | - Qiao-Qiao Du
- Department of Physical Examination Center, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Fei Xue
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Pei-Cheng He
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Hong Jin
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Fu-Yu Wang
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Chun-Feng Liu
- Department of Neurology and Suzhou Clinical Research Center of Neurological Diseases, The Second Affiliated Hospital of Soochow University, Suzhou, China.,Institutes of Neuroscience, Soochow University, Suzhou, China.,Department of Neurology, Suqian First Hospital, Suqian, China
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De Bonis P, Mantovani G, Lofrese G, Cavallo MA, Valpiani G, Morotti C, Scerrati A. Transcranial Sonography versus CT for Postoperative Monitoring After Decompressive Craniectomy. J Neuroimaging 2020; 30:800-807. [PMID: 32681813 DOI: 10.1111/jon.12756] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND AND PURPOSE Computed tomography (CT) is the actual gold standard diagnostic tool for monitoring patients after decompressive craniectomy. It is validated and provides a wide number of information. However, it takes time, expensive, and requires patient transportation. Transcranial sonography (TCS) could represent an alternative diagnostic tool in these patients. The aim of this study is to compare TCS versus CT scan after decompressive craniectomy in terms of diagnosing complications and costs evaluation. METHODS We prospectively enrolled 10 craniectomized patients who were monitored with sonography and CT. Ventricular measurements and possible complications were evaluated by two independent observers. The two methods were compared using Fisher's exact test and Spearman's Rho coefficient. A costs analysis was also conducted. RESULTS A good correlation coefficient (ρ) between CT and TCS was found for frontal horn dimensions (ρ .9929), median cella (ρ .9516), and third ventricle (ρ .8989). All results were statistically significant (P < .0001) and Bland-Altman plots showed no systemic biases. Fisher's exact test showed no statistically significant differences between TCS and CT for all the studied predefined complications. Cost analysis showed a 68% cost reduction in favor of TCS. CONCLUSIONS TCS could be a reliable alternative diagnostic tool for major complications in patients undergoing decompressive craniectomy. It could limit the number of CT scans per patient overcoming several limitations, such as costs, radiation exposure, and need to move the patient.
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Affiliation(s)
- Pasquale De Bonis
- Department of Neurosurgery, S. Anna University Hospital, Ferrara, Italy.,Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Giorgio Mantovani
- Department of Neurosurgery, S. Anna University Hospital, Ferrara, Italy
| | - Giorgio Lofrese
- Neurosurgery Division, "M. Bufalini" Hospital, Cesena, Italy
| | - Michele Alessandro Cavallo
- Department of Neurosurgery, S. Anna University Hospital, Ferrara, Italy.,Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Giorgia Valpiani
- Research Innovation Quality and Accreditation Unit, S. Anna University Hospital, Ferrara, Italy
| | - Chiara Morotti
- Research Innovation Quality and Accreditation Unit, S. Anna University Hospital, Ferrara, Italy
| | - Alba Scerrati
- Department of Neurosurgery, S. Anna University Hospital, Ferrara, Italy.,Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
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Siragusa MA, Réméniéras JP, Bouakaz A, Escoffre JM, Patat F, Dujardin PA, Brizard B, Belzung C, Camus V, El-Hage W, Desmidt T. A systematic review of ultrasound imaging and therapy in mental disorders. Prog Neuropsychopharmacol Biol Psychiatry 2020; 101:109919. [PMID: 32169563 DOI: 10.1016/j.pnpbp.2020.109919] [Citation(s) in RCA: 3] [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: 11/01/2019] [Revised: 03/06/2020] [Accepted: 03/09/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Increasing evidence suggests that ultrasound (US) imaging may provide biomarkers and therapeutic options in mental disorders. We systematically reviewed the literature to provide a global overview of the possibilities of US for psychiatry. METHODS Original English language articles published between January 2000 and September 2019 were identified through databases searching and analyzed to summarize existing evidence according to PRISMA methodology. RESULTS A total of 81 articles were included. Various US techniques and markers have been used in mental disorders, including Transcranial Doppler and Intima-Media Thickness. Most of the studies have focused on characterizing the pathophysiology of mental disorders, especially vascular physiology. Studies on therapeutic applications are still scarce. DISCUSSION US imaging has proved to be useful in characterizing vascular impairment and structural and functional brain changes in mental disorders. Preliminary findings also suggest potential interests for therapeutic applications. Growing evidence suggests that US imaging could provide a non-invasive, portable and low-cost tool for pathophysiological characterization, prognostic assessment and therapeutic applications in mental disorders.
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Affiliation(s)
| | | | - Ayache Bouakaz
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | | | - Frédéric Patat
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; CHU de Tours, Tours, France; CIC 1415, CHU Tours, Inserm, Tours Cedex, France
| | | | - Bruno Brizard
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | | | - Vincent Camus
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; CHU de Tours, Tours, France
| | - Wissam El-Hage
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; CHU de Tours, Tours, France; CIC 1415, CHU Tours, Inserm, Tours Cedex, France
| | - Thomas Desmidt
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; CHU de Tours, Tours, France.
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The role of transcranial sonography in differentiation of dementia subtypes: an introduction of a new diagnostic method. Neurol Sci 2020; 42:275-283. [DOI: 10.1007/s10072-020-04566-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 07/02/2020] [Indexed: 12/21/2022]
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Şenel B, Özel-Kızıl ET, Sorgun MH, Tezcan-Aydemir S, Kırıcı S. Transcranial sonography imaging of brainstem raphe, substantia nigra and cerebral ventricles in patients with geriatric depression. Int J Geriatr Psychiatry 2020; 35:702-711. [PMID: 32100326 DOI: 10.1002/gps.5287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 02/10/2020] [Accepted: 02/13/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Geriatric depression is a special condition associated with a chronic course, treatment resistance and vascular processes. However, its neurobiology has not been fully elucidated. There is no study in geriatric depression evaluating deep brain structures with transcranial sonography (TCS) which is a low-cost, non-invasive and practical tool. The present study aimed to evaluate the changes in the echogenicity of brainstem raphe (BR), substantia nigra (SN) and ventricular diameters by TCS in association with cognitive dysfunctions in patients with geriatric depression. METHODS Echogenicity of BR and SN were assessed and transverse diameters of the third ventricle and frontal horns of the lateral ventricles were measured by TCS in 34 patients with DSM-5 major depression and 31 healthy volunteers aged 60 and older. Cognitive functions were evaluated by using Mini Mental State Examination, Montreal Cognitive Assessment Tool, Clock Drawing Test and Subjective Memory Complaints Questionnaire. RESULTS Although depressed patients had more subjective memory complaints than controls, they had similar cognitive performances. Reduced echogenicity (interrupted/invisible echogenic line) of BR was found to be significantly higher and the ventricular diameters were larger in the depressed group. There was no difference between the groups in terms of SN echogenicity. There was no correlation between ventricular diameters and depression severity or cognitive functions. CONCLUSIONS Results of the present study are important in terms of pointing out neurobiological changes related to geriatric depression which are in parallel with the results of the studies in younger patients with depression. However, long-term follow-up studies are required for accurate differentiation of neurocognitive disorders.
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Affiliation(s)
- Başak Şenel
- Ankara University Faculty of Medicine Department of Psychiatry, Geriatric Psychiatry Unit, Ankara, Turkey
| | - Erguvan T Özel-Kızıl
- Ankara University Faculty of Medicine Department of Psychiatry, Geriatric Psychiatry Unit, Ankara, Turkey
| | - Mine H Sorgun
- Ankara University Faculty of Medicine Department of Neurology, Ankara, Turkey
| | | | - Sevinç Kırıcı
- Ankara University Faculty of Medicine Department of Psychiatry, Geriatric Psychiatry Unit, Ankara, Turkey
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Li K, Ge YL, Gu CC, Zhang JR, Jin H, Li J, Cheng XY, Yang YP, Wang F, Zhang YC, Chen J, Mao CJ, Liu CF. Substantia nigra echogenicity is associated with serum ferritin, gender and iron-related genes in Parkinson's disease. Sci Rep 2020; 10:8660. [PMID: 32457446 PMCID: PMC7250839 DOI: 10.1038/s41598-020-65537-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 04/29/2020] [Indexed: 01/17/2023] Open
Abstract
Substantia nigra (SN) hyperechogenicity is present in most Parkinson’s disease (PD) cases but is occasionally absent in some. To date, age, gender, disease severity, and other factors have been reported to be associated with SN hyperechogenicity in PD. Previous studies have discovered that excess iron deposition in the SN underlies its hyperechogenicity in PD, which may also indicate the involvement of genes associated with iron metabolism in hyperechogenicity. The objective of our study is to explore the potential associations between variants in iron metabolism-associated genes and SN echogenicity in Han Chinese PD. Demographic profiles, clinical data, SN echogenicity and genotypes were obtained from 221 Han Chinese PD individuals with a sufficient bone window. Serum ferritin levels were quantified in 92 of these individuals by immunochemical assay. We then compared factors between PD individuals with SN hyperechogenicity and those with SN hypoechogenicity to identify factors that predispose to SN hyperechogenicity. Of our 221 participants, 122 (55.2%) displayed SN hyperechogenicity, and 99 (44.8%) displayed SN hypoechogenicity. Gender and serum ferritin levels were found to be associated with SN hyperechogenicity. In total, 14 genes were included in the sequencing part. After data processing, 34 common single nucleotide polymorphisms were included in our further analyses. In our data, we also found a significantly higher frequency of PANK2 rs3737084 (genotype: OR = 2.07, P = 0.013; allele: OR = 2.51, P = 0.002) in the SN hyperechogenic group and a higher frequency of PLA2G6 rs731821 (genotype: OR = 0.45, P = 0.016; allele: OR = 0.44, P = 0.011) in the SN hypoechogenic group. However, neither of the two variants was found to be correlated with serum ferritin. This study demonstrated that genetic factors, serum ferritin level, and gender may explain the interindividual variability in SN echogenicity in PD. This is an explorative study, and further replication is warranted in larger samples and different populations.
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Affiliation(s)
- Kai Li
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Yi-Lun Ge
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Chen-Chen Gu
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Jin-Ru Zhang
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Hong Jin
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Jiao Li
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Xiao-Yu Cheng
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Ya-Ping Yang
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Fen Wang
- Institute of Neuroscience, Soochow University, Suzhou, Jiangsu, China
| | - Ying-Chun Zhang
- Department of Ultrasound, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Jing Chen
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Cheng-Jie Mao
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Chun-Feng Liu
- Department of Neurology, the Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China. .,Institute of Neuroscience, Soochow University, Suzhou, Jiangsu, China.
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Trifonova OP, Maslov DL, Balashova EE, Urazgildeeva GR, Abaimov DA, Fedotova EY, Poleschuk VV, Illarioshkin SN, Lokhov PG. Parkinson's Disease: Available Clinical and Promising Omics Tests for Diagnostics, Disease Risk Assessment, and Pharmacotherapy Personalization. Diagnostics (Basel) 2020; 10:E339. [PMID: 32466249 PMCID: PMC7277996 DOI: 10.3390/diagnostics10050339] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/21/2020] [Accepted: 05/22/2020] [Indexed: 12/15/2022] Open
Abstract
Parkinson's disease is the second most frequent neurodegenerative disease, representing a significant medical and socio-economic problem. Modern medicine still has no answer to the question of why Parkinson's disease develops and whether it is possible to develop an effective system of prevention. Therefore, active work is currently underway to find ways to assess the risks of the disease, as well as a means to extend the life of patients and improve its quality. Modern studies aim to create a method of assessing the risk of occurrence of Parkinson's disease (PD), to search for the specific ways of correction of biochemical disorders occurring in the prodromal stage of Parkinson's disease, and to personalize approaches to antiparkinsonian pharmacotherapy. In this review, we summarized all available clinically approved tests and techniques for PD diagnostics. Then, we reviewed major improvements and recent advancements in genomics, transcriptomics, and proteomics studies and application of metabolomics in PD research, and discussed the major metabolomics findings for diagnostics and therapy of the disease.
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Affiliation(s)
- Oxana P. Trifonova
- Laboratory of mass spectrometry-based metabolomics diagnostics, Institute of Biomedical Chemistry, 10 building 8, Pogodinskaya street, 119121 Moscow, Russia; (D.L.M.); (E.E.B.); (P.G.L.)
| | - Dmitri L. Maslov
- Laboratory of mass spectrometry-based metabolomics diagnostics, Institute of Biomedical Chemistry, 10 building 8, Pogodinskaya street, 119121 Moscow, Russia; (D.L.M.); (E.E.B.); (P.G.L.)
| | - Elena E. Balashova
- Laboratory of mass spectrometry-based metabolomics diagnostics, Institute of Biomedical Chemistry, 10 building 8, Pogodinskaya street, 119121 Moscow, Russia; (D.L.M.); (E.E.B.); (P.G.L.)
| | - Guzel R. Urazgildeeva
- 5th Neurological Department (Department of Neurogenetics), Research Centre of Neurology, Volokolamskoe shosse, 80, 125367 Moscow, Russia; (G.R.U.); (D.A.A.); (E.Y.F.); (V.V.P.); (S.N.I.)
| | - Denis A. Abaimov
- 5th Neurological Department (Department of Neurogenetics), Research Centre of Neurology, Volokolamskoe shosse, 80, 125367 Moscow, Russia; (G.R.U.); (D.A.A.); (E.Y.F.); (V.V.P.); (S.N.I.)
| | - Ekaterina Yu. Fedotova
- 5th Neurological Department (Department of Neurogenetics), Research Centre of Neurology, Volokolamskoe shosse, 80, 125367 Moscow, Russia; (G.R.U.); (D.A.A.); (E.Y.F.); (V.V.P.); (S.N.I.)
| | - Vsevolod V. Poleschuk
- 5th Neurological Department (Department of Neurogenetics), Research Centre of Neurology, Volokolamskoe shosse, 80, 125367 Moscow, Russia; (G.R.U.); (D.A.A.); (E.Y.F.); (V.V.P.); (S.N.I.)
| | - Sergey N. Illarioshkin
- 5th Neurological Department (Department of Neurogenetics), Research Centre of Neurology, Volokolamskoe shosse, 80, 125367 Moscow, Russia; (G.R.U.); (D.A.A.); (E.Y.F.); (V.V.P.); (S.N.I.)
| | - Petr G. Lokhov
- Laboratory of mass spectrometry-based metabolomics diagnostics, Institute of Biomedical Chemistry, 10 building 8, Pogodinskaya street, 119121 Moscow, Russia; (D.L.M.); (E.E.B.); (P.G.L.)
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Mašková J, Školoudík D, Štofaniková P, Ibarburu V, Kemlink D, Zogala D, Trnka J, Krupička R, Šonka K, Růžička E, Dušek P. Comparative study of the substantia nigra echogenicity and 123I-Ioflupane SPECT in patients with synucleinopathies with and without REM sleep behavior disorder. Sleep Med 2020; 70:116-123. [PMID: 32403038 DOI: 10.1016/j.sleep.2020.02.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 01/16/2020] [Accepted: 02/14/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Hyperechogenicity of the substantia nigra (SN) and abnormal dopamine transporter-single-photon emission computed tomography (DAT-SPECT) are biomarkers commonly used in the assessment of prodromal synucleinopathy. Our goals were as follows: (1) to compare echogenicity of SN in idiopathic rapid eye movement (REM) behavior disorder (iRBD), Parkinson's disease (PD) without RBD (PD-noRBD), PD with RBD (PD + RBD), and control subjects; and (2) to examine association between SN degeneration assessed by DAT-SPECT and SN echogenicity. PATIENTS/METHODS A total of 61 subjects with confirmed iRBD were examined using Movement Disorders Society-unified PD rating scale (MDS-UPDRS), TCS (transcranial sonography) and DAT-SPECT. The results were compared with 44 patients with PD (25% PD + RBD) and with 120 age-matched healthy subjects. RESULTS AND CONCLUSION The abnormal SN area was found in 75.5% PD, 23% iRBD and 7.3% controls. Median SN echogenicity area in PD (0.27 ± 0.22 cm2) was higher compared to iRBD (0.07 ± 0.07 cm2; p < 0.0001) and controls (0.05 ± 0.03 cm2; p < 0.0001). SN echogenicity in PD + RBD was not significantly different from PD-noRBD (0.30 vs. 0.22, p = 0.15). Abnormal DAT-SPECT was found in 16 iRBD (25.4%) and 44 PD subjects (100%). No correlation between the larger SN area and corresponding putaminal binding index was found in iRBD (r = -0.13, p = 0.29), nor in PD (r = -0.19, p = 0.22). The results of our study showed that: (1) SN echogenicity area in iRBD was higher compared to controls, but the hyperechogenicity was present only in a minority of iRBD patients; (2) SN echogenicity and DAT-SPECT binding index did not correlate in either group; and (3) SN echogenicity does not differ between PD with/without RBD.
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Affiliation(s)
- J Mašková
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital Prague, Czech Republic.
| | - D Školoudík
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital Prague, Czech Republic; Department of Neurology, University Hospital Ostrava, Ostrava, Czech Republic
| | - P Štofaniková
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital Prague, Czech Republic
| | - V Ibarburu
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital Prague, Czech Republic
| | - D Kemlink
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital Prague, Czech Republic
| | - D Zogala
- Institute of Nuclear Medicine, First Faculty of Medicine, Charles University and General University Hospital Prague, Czech Republic
| | - J Trnka
- Institute of Nuclear Medicine, First Faculty of Medicine, Charles University and General University Hospital Prague, Czech Republic
| | - R Krupička
- Department of Biomedical Informatics, Czech Technical University in Prague, Faculty of Biomedical Engineering, Czech Republic
| | - K Šonka
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital Prague, Czech Republic
| | - E Růžička
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital Prague, Czech Republic
| | - P Dušek
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital Prague, Czech Republic; Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital Prague, Czech Republic
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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.
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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
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Xu R, Chen G, Mao Z, Gao H, Deng Y, Tao A. Diagnostic Performance of Transcranial Sonography for Evaluating Substantia Nigra Hyper-echogenicity in Patients with Parkinson's Disease. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:1208-1215. [PMID: 32102740 DOI: 10.1016/j.ultrasmedbio.2020.01.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 01/14/2020] [Accepted: 01/20/2020] [Indexed: 06/10/2023]
Abstract
To determine the diagnostic performance of transcranial sonography (TCS) in assessing increased echogenic area of the substantia nigra (SN) in patients with Parkinson's disease (PD). Institutional review board approval was obtained for this retrospective study. A total of 278 PD patients (mean age: 64.7 ± 9.8 y, 100 women) and 300 healthy control patients (mean age: 63.6 ± 9.3 y, 97 women) were referred for TCS assessment of SN hyper-echogenicity (SN+) from June 2016 to December 2018. Two sonographers independently measured the sizes of the echogenic areas of the SN by TCS imaging in both PD patients and healthy controls. The diagnostic sensitivity, specificity and accuracy of TCS imaging were compared between PD patients and healthy controls. Inter-rater agreement was assessed with the Cohen's κ statistic. The sensitivity, specificity and accuracy of readers 1 and 2, respectively, for the identification of SN+ in TCS were 90.3% and 89.6% (251 and 249 of 278), 89.3% and 88.3% (268 and 265 of 300) and 89.8% and 88.9% (519 and 514 of 578). Inter-observer agreement was excellent (к = 0.84). The area under the receiver operating characteristic curve (AUC) for differentiation of PD patients from healthy controls was 0.92 for reader 1 and 0.91 for reader 2. Cutoff values of 0.20 and 0.21 cm2 were derived from the assessments performed by readers 1 and 2, respectively. We defined 0.20 cm2 as the optimal cutoff value because it had a higher AUC. TCS is a promising diagnostic technique and can be very helpful in differentiating PD patients from healthy individuals.
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Affiliation(s)
- Renfan Xu
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Guangzhi Chen
- Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - 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
| | - Youbin Deng
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Anyu Tao
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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Skowronska M, Litwin T, Kurkowska-Jastrzębska I, Członkowska A. Transcranial sonography changes in heterozygotic carriers of the ATP7B gene. Neurol Sci 2020; 41:2605-2612. [PMID: 32270360 PMCID: PMC7419484 DOI: 10.1007/s10072-020-04378-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 03/27/2020] [Indexed: 11/01/2022]
Abstract
PURPOSE Wilson's disease (WD) is an autosomal recessive disorder of ATP7B gene leading to impaired copper metabolism. Brain imaging, such as magnetic resonance (MR) and transcranial sonography (TCS) in WD patients, shows changes mostly in the basal ganglia. Heterozygotic carriers of one faulty ATP7B gene should not exhibit symptoms of WD, but one in three heterozygotes has copper metabolism abnormalities. This study examined heterozygote ATP7B mutation carriers using TCS to assess any basal ganglia changes compared with healthy controls. METHODS Heterozygote carriers and healthy volunteers underwent the same standard MR and TCS imaging protocols. Heterozygotes were followed for 5 years and monitored for the development of neurological symptoms. RESULTS The study assessed 34 heterozygotes (21 women), with mean age of 43 years (range of 18 to 74 years) and 18 healthy controls (13 women), with mean age of 47 years (range of 20 to 73 years). Bilateral lenticular nucleus (LN) hyperechogenicity was found in 25 heterozygotes, but none of the controls (p < 0.001). Bilateral substantia nigra (SN) hyperechogenicity was found in 8 heterozygotes and one control; another 3 heterozygotes had unilateral SN hyperechogenicity (p = 0.039 for the right; p = 0.176 for the left). Heterozygotes had larger SN area on both sides compared with controls (p = 0.005 right; p = 0.008 left). CONCLUSIONS SN and LN hyperechogenicity were more frequent in heterozygotes than in controls, probably due to copper accumulation, but it remains unknown if this predisposes to brain neurodegeneration.
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Affiliation(s)
- Marta Skowronska
- 2nd Department of Neurology, Institute of Psychiatry and Neurology, 02-957, Warsaw, Poland.
| | - Tomasz Litwin
- 2nd Department of Neurology, Institute of Psychiatry and Neurology, 02-957, Warsaw, Poland
| | | | - Anna Członkowska
- 2nd Department of Neurology, Institute of Psychiatry and Neurology, 02-957, Warsaw, Poland.,Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland
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Iranzo A, Stefani A, Niñerola-Baizan A, Stokner H, Serradell M, Vilas D, Holzknecht E, Gaig C, Pavia J, Lomeña F, Reyes D, Seppi K, Santamaria J, Högl B, Tolosa E, Poewe W. Left-hemispheric predominance of nigrostriatal deficit in isolated REM sleep behavior disorder. Neurology 2020; 94:e1605-e1613. [DOI: 10.1212/wnl.0000000000009246] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Accepted: 10/17/2019] [Indexed: 01/01/2023] Open
Abstract
ObjectiveUnilateral onset of parkinsonism due to nigrostriatal damage of the contralateral hemisphere is frequent in Parkinson disease (PD). There is evidence for a left-hemispheric bias of motor asymmetry in right-handed patients with PD indicating a hemispheric dominance. Isolated REM sleep behavior disorder (IRBD) constitutes the prodromal stage of PD and other synucleinopathies. To test the hypothesis that right-handed patients with IRBD exhibit left-hemispheric predominance of subclinical nigrostriatal dysfunction, we evaluated this aspect using neuroimaging instruments.MethodsIn 167 right-handed patients with IRBD without parkinsonism, we evaluated in each hemisphere the integrity of the striatal dopaminergic terminals by dopamine transporter (DAT)-SPECT and the substantia nigra echogenicity by transcranial sonography.ResultsDAT-SPECT showed lower specific binding ratio (SBR) in the left striatum and left caudate nucleus than in the right striatum and right caudate nucleus. The percentage of patients with lower SBR was greater in the left striatum and left caudate nucleus than in the right striatum and right caudate nucleus. In those who developed a synucleinopathy in <5 years from DAT-SPECT, there was a lower SBR in the left putamen and left caudate nucleus than in the right putamen and right caudate nucleus. Substantia nigra echogenic size was greater in the left than in the right side in patients with hyperechogenicity and among individuals who phenoconverted in <5 years from transcranial sonography.ConclusionRight-handed patients with IRBD exhibit left-hemispheric predominance of subclinical nigrostriatal dysfunction. In premotor PD, the neurodegenerative process begins asymmetrically, initially impairing the nigrostriatal system of the dominant hemisphere.
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Alster P, Madetko N, Koziorowski D, Friedman A. Progressive Supranuclear Palsy-Parkinsonism Predominant (PSP-P)-A Clinical Challenge at the Boundaries of PSP and Parkinson's Disease (PD). Front Neurol 2020; 11:180. [PMID: 32218768 PMCID: PMC7078665 DOI: 10.3389/fneur.2020.00180] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 02/24/2020] [Indexed: 12/11/2022] Open
Abstract
Progressive Supranuclear Palsy (PSP) and Parkinson's Disease (PD), especially in their early stages, show overlapping clinical manifestations. The criteria for the diagnosis of PSP, released in 2017, indicate four basic features of the disease—postural instability (P), akinesia (A), oculomotor dysfunction (O) and cognitive and lingual disorders (C), which clarify the interpretation of the disease. There is growing interest in the second most common variant of PSP—parkinsonism predominant PSP-P. It is observed in up to 35% of cases. The diagnosis of PSP-P requires the presence of akinetic-rigid predominantly axial and levodopa resistant parkinsonism (A2) or parkinsonism with tremor and/or asymmetric and/or levodopa responsive (A3). The development of supplementary methods of examination added new insights to observations related to PSP-P. Among the methods recently analyzed are freezing of swallowing and speech breathing assessment, transcranial sonography, and various methods using magnetic resonance imaging, such as pons/midbrain area ratio and magnetic resonance parkinsonism index (MRPI), fractional anisotropy or mean diffusivity. The proper examination of overlapping parkinsonian syndromes, regardless of the development of the method of examination, remains an incompletely explored issue. The aim of this review is to elucidate which factors may be interpreted as influential in the differential diagnosis of PSP-P, PSP-RS and postural instability and gait difficulty (PIGD) subtype of Parkinson's disease (PD).
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Affiliation(s)
- Piotr Alster
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
| | - Natalia Madetko
- Department of Neurology, Wrocław Medical University, Wrocław, Poland
| | | | - Andrzej Friedman
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
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Školoudík D, Mašková J, Dušek P, Blahuta J, Soukup T, Burgetová A, Bártová P. Digitized Image Analysis of Insula Echogenicity Detected by TCS-MR Fusion Imaging in Wilson's and Early-Onset Parkinson's Diseases. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:842-848. [PMID: 31924422 DOI: 10.1016/j.ultrasmedbio.2019.12.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 11/02/2019] [Accepted: 12/11/2019] [Indexed: 06/10/2023]
Abstract
Transcranial sonography (TCS) can reveal pathology in brain structures including insula. This study compared insula echogenicity among 22 patients with Wilson's disease (WD), 21 patients with early-onset Parkinson's disease (EO-PD) and 24 healthy patients. Echogenicity of predefined brain structures (insula, lentiform nucleus, caudate nucleus, substantia nigra and raphe nuclei) was evaluated using digitized analysis of TCS fusion imaging with magnetic resonance. Cortical, subcortical and cerebellar atrophy and ventricle diameters were determined from magnetic resonance images. The mean echogenicity index of insula did not differ between males and females (p = 0.92), but the echogenicity of insula was higher in patients with WD than in patients with EO-PD and healthy patients (p < 0.05). The substantia nigra echogenicity was higher in patients with EO-PD, and lentiform nucleus echogenicity was higher in patients with WD (p < 0.05). The echogenicity of insula correlated with lentiform nucleus echogenicity (r = 0.75) but not with age (r = -0.14), disease duration (r = -0.36), symptom severity (r = 0.28), cortical (r = 0.11) nor subcortical (r = 0.05) atrophy.
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Affiliation(s)
- David Školoudík
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic; Department of Neurology, University Hospital Ostrava, Ostrava, Czech Republic.
| | - Jana Mašková
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Petr Dušek
- Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic; Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jiří Blahuta
- Institute of Computer Science, Faculty of Philosophy and Science, Silesian University in Opava, Opava, Czech Republic
| | - Tomáš Soukup
- Institute of Computer Science, Faculty of Philosophy and Science, Silesian University in Opava, Opava, Czech Republic
| | - Andrea Burgetová
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Petra Bártová
- Department of Neurology, Ostrava University Medical Faculty and University Hospital Ostrava, Ostrava, Czech Republic
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Preston C, Alvarez AM, Barragan A, Becker J, Kasoff WS, Witte RS. High resolution transcranial acoustoelectric imaging of current densities from a directional deep brain stimulator. J Neural Eng 2020; 17:016074. [PMID: 31978914 PMCID: PMC7446234 DOI: 10.1088/1741-2552/ab6fc3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE New innovations in deep brain stimulation (DBS) enable directional current steering-allowing more precise electrical stimulation of the targeted brain structures for Parkinson's disease, essential tremor and other neurological disorders. While intra-operative navigation through MRI or CT approaches millimeter accuracy for placing the DBS leads, no existing modality provides feedback of the currents as they spread from the contacts through the brain tissue. In this study, we investigate transcranial acoustoelectric imaging (tAEI) as a new modality to non-invasively image and characterize current produced from a directional DBS lead. tAEI uses ultrasound (US) to modulate tissue resistivity to generate detectable voltage signals proportional to the local currents. APPROACH An 8-channel directional DBS lead (Infinity 6172ANS, Abbott Inc) was inserted inside three adult human skulls submerged in 0.9% NaCl. A 2.5 MHz linear array delivered US pulses through the transtemporal window and focused near the contacts on the lead, while a custom amplifier and acquisition system recorded the acoustoelectric (AE) interaction used to generate images. MAIN RESULTS tAEI detected monopolar current with stimulation pulses as short as 100 µs with an SNR ranging from 10-27 dB when using safe US pressure (mechanical indices <0.78) and injected current of ~2 mA peak amplitude. Adjacent contacts were discernable along the length and within each ring of the lead with a mean radial separation between contacts of 2.10 and 1.34 mm, respectively. SIGNIFICANCE These results demonstrate the feasibility of tAEI for high resolution mapping of directional DBS currents using clinically-relevant stimulation parameters. This new modality may improve the accuracy for placing the DBS leads, guide calibration and programming, and monitor long-term performance of DBS for treatment of Parkinson's disease.
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Affiliation(s)
- Chet Preston
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, United States of America
| | - Alexander M Alvarez
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, United States of America
| | - Andres Barragan
- Department of Computer Science, University of Arizona, Tucson, AZ, United States of America
| | - Jennifer Becker
- Department of Medical Imaging, University of Arizona, Tucson, AZ, United States of America
| | - Willard S Kasoff
- Department of Surgery, University of Arizona, Tucson, AZ, United States of America
| | - Russell S Witte
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, United States of America
- Department of Medical Imaging, University of Arizona, Tucson, AZ, United States of America
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50
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Crespo-Cuevas AM, López-Cancio E, Cáceres C, González A, Ispierto L, Hernández-Pérez M, Mataró M, Planas A, Canento T, Martín L, Arenillas JF, Alvarez R, Vilas D. Third Ventricle Width Assessed by Transcranial Sonography as Predictor of Long-Term Cognitive Impairment. J Alzheimers Dis 2020; 73:741-749. [DOI: 10.3233/jad-190949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Ane Miren Crespo-Cuevas
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Elena López-Cancio
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
- Department of Neurology, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Cynthia Cáceres
- Department of Neurosciences, Neuropsychology Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Anna González
- Department of Neurosciences, Neuropsychology Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Lourdes Ispierto
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - María Hernández-Pérez
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - María Mataró
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
- Institut de Neurociències, University of Barcelona, Barcelona, Spain
- Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Anna Planas
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Tamara Canento
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Lorena Martín
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | | | - Ramiro Alvarez
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Dolores Vilas
- Department of Neurosciences, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
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