Echogenicity of substantia nigra determined by transcranial ultrasound correlates with severity of parkinsonian symptoms induced by neuroleptic therapy

Berg, Daniela; Jabs, B.; Merschdorf, Ursula; Beckmann, H.; Becker, Georg

doi:10.1016/s0006-3223(01)01190-8

Cited by 102 publications

(52 citation statements)

References 14 publications

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“…10 Substantia nigra echogenicity was correlated to presynaptic dopaminergic dysfunction elicited by single photon emission computed tomography in patients with Parkinson disease 16 and with the severity of parkinsonism induced by neuroleptics in patients with schizophrenia. 17 However, there is still disagreement about how abnormal extension of substantia nigra echogenicity is related to the pathogenic substrate of Parkinson disease. Furthermore, the functional significance of increased substantia nigra echogenicity in children with ADHD is yet unknown.…”

Section: Discussionmentioning

confidence: 99%

Structural abnormality of the substantia nigra in children with attention-deficit hyperactivity disorder

Romanos

Weise

Schliesser

et al. 2010

jpn

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55Background: Structural abnormality of the substantia nigra can be detected by transcranial sonography in neuropsychiatric disorders such as Parkinson disease and restless legs syndrome. We investigated echogenicity of the substantia nigra as a potential structural marker for dysfunction of the nigrostriatal dopamine system in children with attention-deficit hyperactivity disorder (ADHD). Methods: We used a blinded design and determined echogenicity of the substantia nigra by use of transcranial sonography in 22 children with ADHD and 22 healthy controls matched for age and sex. Results: The echogenic substantia nigra area was significantly larger in ADHD patients than in healthy controls (F 1,42 = 9.298, p = 0.004, effect size = 0.92). We found no effects of age or sex. Limitations: Owing to a lack of dimensional assessment, we could not analyze the correlation between echogenicity and clinical symptoms. Conclusion: Our results support the hypothesis that the nigrostriatal dopaminergic system is abnormal in children with ADHD.

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Section: Discussionmentioning

confidence: 99%

Structural abnormality of the substantia nigra in children with attention-deficit hyperactivity disorder

Romanos

Weise

Schliesser

et al. 2010

jpn

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“…SNH is less frequently encountered in essential tremor, vascular parkinsonism, multiple system atrophy and progressive supranuclear palsy while this echo feature occurs in most PD patients 1,4,5 . SNH can be found in a minority of healthy subjects (10%) and they are more likely to develop extrapyramidal signs and symptoms following administration of neuroleptic 1,2,5 .…”

Section: Discussionmentioning

confidence: 99%

“…Future longitudinal studies must address if SNH can help to identify PD patients at preclinical stages mainly if considered in conjunction with other nonmotor signs of PD, such as depression, olfactory dysfunction, neuropsychological deficits and idiopathic REM sleep behavior disorder 5 . If this idea is true, PD could be identified before manifestation of typical signs and symptoms, allowing development of neuroprotective therapies [1][2][3][4][5] .…”

Section: Case Reportmentioning

confidence: 99%

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Echogenicity of the substantia nigra region in Parkinson's disease

Bor-Seng-Shu

Almeida

Andrade

et al. 2012

Arq. Neuro-Psiquiatr.

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Idiopathic Parkinson's disease (PD) is a progressive neurodegenerative disorder which affects 1 to 2% of the population over 60 years. The differential diagnosis between PD and atypical Parkinsonian syndromes is usually difficult in the medical practice, mainly in the beginning of clinical manifestation. Modern neuroimaging techniques, such as PET and SPECT, have proved to be useful in the clinical scenario, although expensive and inaccessible 1 .Transcranial sonography (TCS) of the brain has recently emerged as a novel diagnostic test for the evaluation of movement disorders 1,2 . The authors report a patient with PD in whom TCS disclosed hyperechogenicity of the substantia nigra (SN) region; the significance of this finding (SNH) in the clinical practice was discussed. CASE REPoRTA 54-year-old female had a 16-year history of PD which followed a characteristic course with gradually worsening symptoms. Hand tremor at rest began initially on the left side and, after 3 years, both sides were affected. Current neurological examination revealed an asymmetric tremor, bradykinesia and muscle rigidity; there were posture and balance dysfunctions, and reduction of automatic movements. Results of brain CT and MRI were normal. TCS of the brain parenchyma disclosed a SN echogenic area greater than 0.20 cm 2 , bilaterally, fulfilling the criteria for SNH (Figure). Written informed consent was obtained from the patient. DiSCuSSionSNH, visualized by TCS, has been considered a biological marker for PD. This ultrasound sign is found in the majority of PD patients (>90%) and has been demonstrated to be associated with functional impairment of the nigrostriatal dopaminergic system 1-3 .Animal and human postmortem analyses have attributed increased iron content in the SN as a cause for the hyperechogenicity 1,2 . It is not known, however, whether increased SN iron levels may cause oxidative stress and secondary neuronal damage or whether SN degenerative process leads to increased iron content in the SN region 3 .SNH is less frequently encountered in essential tremor, vascular parkinsonism, multiple system atrophy and progressive supranuclear palsy while this echo feature occurs in most PD patients 1,4,5 . SNH can be found in a minority of healthy subjects (10%) and they are more likely to develop extrapyramidal signs and symptoms following administration of neuroleptic 1,2,5 .Some factors limit the usefulness of TCS, such as its dependence on the operator experience and the lack of temporal acoustic windows (about 10% of patients) 1 . No correlation Figure. Transcranial sonographic images of the midbrain. The butterfly-shaped midbrain and the substantia nigra region hyperechogenicity were encircled.

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“…Considering the possibility of on-going neurodegeneration, these healthy individuals without a sign of parkinsonism but with SN+ were further investigated in several studies, which revealed that, (i) healthy individuals with SN+ may have nigrostriatal impairment detected by reduced presynaptic dopaminergic tracer uptake [9,10], (ii) show sub-clinical motor slowing [11,12], (iii) perform slightly worse in cognitive or olfaction tests [13,14] compared to individuals with normal SN echogenicity and (iv) are more prone to develop severe extrapyramidal symptoms after disposure to neuroleptic drugs [15]. Furthermore, healthy individuals with increased risk for PD, such as positive family history, asymptomatic carriers of mutations associated with PD [16,17] or REM sleep behavior disorder [18,19] also exhibited a higher rate of SN + compared to the ones without these risk and prodromal markers.…”

Section: Sn Hyperechogenicity As a Potential Premotor Markermentioning

confidence: 99%

Substantia Nigra Hyperechogenicity for the Early Detection of Parkinson’s Disease

Yılmaz¹,

Berg²

2017

J Neurol Neurophysiol

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Echogenicity of substantia nigra determined by transcranial ultrasound correlates with severity of parkinsonian symptoms induced by neuroleptic therapy

Cited by 102 publications

References 14 publications

Structural abnormality of the substantia nigra in children with attention-deficit hyperactivity disorder

Structural abnormality of the substantia nigra in children with attention-deficit hyperactivity disorder

Echogenicity of the substantia nigra region in Parkinson's disease

Substantia Nigra Hyperechogenicity for the Early Detection of Parkinson’s Disease

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