Echogenicity of the Substantia Nigra

Berg, Daniela; Roggendorf, Wolfgang; Schröder, Ute; Klein, Rüdiger; Tatschner, Thomas; Benz, P.; Tucha, Oliver; Preier, Michael; Lange, Klaus W.; Reiners, Karlheinz; Gerlach, Manfred; Becker, Georg

doi:10.1001/archneur.59.6.999

Cited by 345 publications

(52 citation statements)

References 21 publications

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“…The reasons for the increased SN echogenic area in PD are not entirely clear. However, it is likely that SN+ reflects pathological alterations related to an increased SN iron content [10,11] and may represent a surrogate marker of an increased vulnerability of the nigrostriatal dopaminergic system [2,10]. All studies using this technique in patients with PD have so far been performed in hospital-based series or experimental cohorts.…”

Section: Introductionmentioning

confidence: 94%

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Substantia Nigra Hyperechogenicity as a Marker for Parkinson's Disease: A Population-Based Study

Mahlknecht

Seppi²,

Stockner³

et al. 2013

Neurodegener Dis

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Background: The clinical diagnosis of Parkinson's disease (PD) is currently anchored in its cardinal motor symptoms. According to hospital-based studies, an enlarged echogenicity in the area of the substantia nigra (SN) assessed with transcranial sonography (TCS) may represent a useful biomarker in the diagnosis of PD. Objective: To evaluate SN hyperechogenicity as a marker for PD in the Bruneck Study cohort, which is representative of the general elderly community. Methods: The diagnostic accuracy of TCS in distinguishing clinically diagnosed PD from nonparkinsonian subjects was assessed in 574 subjects from this cohort. Results: There was a good diagnostic accuracy of TCS in distinguishing PD subjects from nonparkinsonian subjects with an area under the curve value of 0.82. At a receiver-operating characteristic curve analysis-based cutoff value for SN hyperechogenicity of 0.18 cm², TCS had a sensitivity of 88.2% (95% confidence interval, CI, 64.4-98.0), a specificity of 77.0% (95% CI 72.8-80.6), a positive predictive value of 12.7% (95% CI 7.8-20.0) and a negative predictive value of 99.4% (95% CI 97.8-100.0) for subjects with clinically definite PD at baseline. When analyzing the same population after 5 years with regard to the presence of known and newly diagnosed PD cases, baseline TCS yielded very similar diagnostic accuracy values. Conclusion: SN hyperechogenicity may represent a useful biomarker for PD not only in a hospital-based setting but also in the general community.

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Section: Introductionmentioning

confidence: 94%

“…This ultrasound signal abnormality has also been consistently detected in at least 10% of healthy controls in a number of studies [2,8,9]. Healthy subjects with SN+ may show functional deficits in the nigrostriatal dopaminergic pathway [8,10]. The reasons for the increased SN echogenic area in PD are not entirely clear.…”

Section: Introductionmentioning

confidence: 99%

Substantia Nigra Hyperechogenicity as a Marker for Parkinson's Disease: A Population-Based Study

Mahlknecht

Seppi²,

Stockner³

et al. 2013

Neurodegener Dis

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“…Therefore, mitochondrial abnormalities coupled with metal dysregulation of metal homeostasis are key features closely associated with ROS formation responsible for the RNA oxidation in AD [94]. Interestingly, mitochondrial abnormalities [95,96] and metal ion dysregulation [97,98] are also found in the substantia nigra of PD making this mechanism a common theme in neurodegenerative cascades.…”

Section: Sources Of Reactive Oxygen Species (Ros) Responsible For Celmentioning

confidence: 99%

Oxidative RNA Damage and Neurodegeneration

Nunomura¹,

Moreira

Takeda³

et al. 2007

CMC

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“…Consequently, the evaluation of SN echogenicity by TCS, constitutes a promising screening instrument in a population at risk from IPD. In fact, this technique is capable of performing an early preclinical diagnosis, that allows starting treatment in the premotor stage, before the majority of neurons are lost with consequently greater neuroprotective effect [41,50,54,89].…”

Section: Resultsmentioning

confidence: 99%

“…Approximately all the echogenic sizes on one side that are smaller than 0.20 cm 2 are classified as normally echogenic; sizes between 0.20 cm 2 and 0.25 cm 2 are categorized as moderately hyperechogenic and sizes of 0.25 cm 2 and greater, are classified as markedly hyperechogenic [18,[39][40][41].…”

Section: Technical Aspectsmentioning

confidence: 99%

Update on Transcranial Sonography Applications in Movement Disorders

Godani¹,

Canavese²,

Sette³

et al. 2014

J Diagn Imaging Ther

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Over the past 20 years transcranial B-mode sonography (TCS) of brain parenchyma is being increasingly used as a diagnostic tool in movement disorders. The most widely recognised finding for movement disorders has been an increase in echogenicity of the substantia nigra, an area of the midbrain that is affected in idiopathic Parkinson's disease (IPD). This finding has enabled a reliable diagnosis of IPD with high predictive values. Other sonographic features -such as hypoechogenicity of the brainstem raphe and hyperechogenicity of the lentiform nucleus -might help to increase the differential diagnosis of IPD and other movement disorders. In comparison with other neuroimaging modalities such as magnetic resonance imaging (MRI) and computed tomography (CT), TCS can currently be performed with portable machines and has the advantages of non-invasiveness with high resistance to movement artifacts. In distinct brain disorders TCS detects abnormalities that cannot be visualized -or can only be visualized with significant effort -with other imaging methods. This present update summarizes the current methodological standards and defines the assessment of diagnostically relevant deep brain structures such as substantia nigra, brainstem raphe, basal ganglia and ventricles

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Echogenicity of the Substantia Nigra

Cited by 345 publications

References 21 publications

Substantia Nigra Hyperechogenicity as a Marker for Parkinson's Disease: A Population-Based Study

Substantia Nigra Hyperechogenicity as a Marker for Parkinson's Disease: A Population-Based Study

Oxidative RNA Damage and Neurodegeneration

Update on Transcranial Sonography Applications in Movement Disorders

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