Transcranial brain parenchyma sonography in movement disorders: State of the art

Walter, Uwe; Behnke, Stefanie; Eyding, Jens; Niehaus, L.; Postert, Thomas; Seidel, Günter; Berg, Daniela

doi:10.1016/j.ultrasmedbio.2006.07.021

Cited by 221 publications

(271 citation statements)

References 46 publications

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“…Axial TCS scans were obtained bilaterally at the level of the midbrain through the temporal acoustic bone window using a penetration depth of 16 cm and a dynamic range of 45 dB. 11 For planimetric assessment of the echogenic substantia nigra area, we saved on the computer at least 3 ultrasound slides for each side with clearly visible and definable substantia nigra. The outer circumference of the echogenic substantia nigra area was manually circled off-line by an experienced sonographer (D.W.), who was also unaware of the clinical status of the participants.…”

Section: Transcranial Sonographymentioning

confidence: 99%

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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: Transcranial Sonographymentioning

confidence: 99%

“…11 The size of the echogenic area was quantified using the freely distributed computer software GIMP (version 2.2.13; GNU Image Manipulation Program; www.gimp.org) allowing off-line quantitative analysis of images in bitmap format. For the purpose of quality control, a second investigator (M.R.)…”

Section: Transcranial Sonographymentioning

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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“…Patient lied in supine position; the ultrasound probe was pressed on the temporal window, at the temporal squama before the ear as recommended else-where [15]. Axial plane on orbitomeatal line was assessed to evaluate midbrain raphe [16].…”

Section: Methodsmentioning

confidence: 99%

Brainstem Midline Assessed by Transcranial Sonography in Parkinson's Disease: Further Evidence of a Different Etiopathogenesis of Alexithymia and Depression

Giacomo¹,

D’Agostino²,

Angelis³

et al. 2017

J Neurol Neurophysiol

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Objective: Parkinson's disease (PD) is often characterized by altered emotional processing, such as depression and alexithymia. Alexithymic and depressive symptoms may be partially overlapping and the relative independence of these two disorders is strongly debated. Reduced echogenicity of midbrain raphe, evaluated with transcranial sonography (TCS), is a characteristic finding in depression associated with PD. No data are available on brainstem's echogenicity in alexithymic PD patients. We assessed, by means of transcranial sonography, possible differences between PD patient with or without alexithymia and/or depression. Methods:We recruited 22 PD patients among our local cohort of 200 patients referred to our Movement Disorder Center during 2014. All patients were treated with optimal dose of dopaminomimetic (L-DOPA EQ mg 499.7 ± 256.3) and underwent neuropsychological tests including Beck Depression Inventory (BDI) and Toronto Alexithymia . Motor symptoms were assessed with Unified Parkinson's Disease Rating Scale (UPDRS III) and modified Hoehn and Yahr scale (H&Y). TCS was performed, through temporal window, using a color-coded phasedarray ultrasound system (SONOS 7500), to evaluate midbrain raphe (0=absent, 1=discontinuous, 2=continuous).Results: TAS-20 and BDI identified 4 patients with depression without alexithymic symptoms (18.18%), 7 alexithymic patients without depression (31.82%), 5 PD patients with depression and alexithymia (22.73%) and 6 PD patients without any of the two disorders (27.27%). At statistical analysis hypoechogenicity correlated with BDI score and the presence of alexithymia was not significantly correlated with absent or discontinuous raphe. Conclusion:The study evidenced the presence of hypoechogenicity in the midbrain raphe in PD patient with depression. No alteration of midbrain raphe was found in PD patients with alexithymia. These findings suggest that while depression in PD may involve central component of brainstem midline, constituting the basal limbic system, called mesocorticolimbic pathway, alteration in alexithymia does not affect the midbrain. This study provides further evidence that depression and alexithymia are independent affective disorder.

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“…In addition to these imaging modalities, changes in the size and structure of the substantia nigra (SN) can be detected by transcranial sonography (TCS) (ref. [7][8][9][10][11] ).…”

Section: Introductionmentioning

confidence: 99%

“…Recent studies reported increased SN echogenicity in 91-100% of PD patients, with boundary enlargements between 0.20-0.25 cm 2 depending on the specific ultrasound system used [8][9][10][11] . In contrast, a hyperechogenic enlarged SN is detectable in only 8-14% of healthy volunteers [8][9][10][11] . Some apparently healthy volunteers with positive TCS finding will later developed symptoms of PD (ref.…”

Section: Introductionmentioning

confidence: 99%

A new program for highly reproducible automatic evaluation of the substantia nigra from transcranial sonographic images

Blahuta¹,

Soukup²,

Jelínková³

et al. 2014

BIOMED PAP

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Aims. Recent studies report increased echogenicity of the substantia nigra (SN) in patients with Parkinson's disease (PD) using transcranial sonography (TCS). However, the main limitation to TCS is its dependence on the sonographer's experience. Experimental software for quantitative evaluation of the echogenic SN area was thus developed by us. The aim of this study was to test the reliability of the data using developed B-Mode Assist software in patients with parkinsonism and in healthy volunteers. Methods. The SN was imaged from the right temporal bone window in mesencephalic plane using TCS. DICOM images of SN were saved, converted into JPEG format, encoded and processed. Two observers performed 3 automatic evaluations of the SN area (measurements of SN area in each gray scale intensity inside the region of interest) by counting the standard deviation of all 6 measurements using developed software. The average value of all 3 measurements of each observer was used for computing Cohen's kappa coefficient to determine inter-observer correlations. Cohen's kappa coefficients as an intra-observer correlation for observer 1 and observer 2 were counted from the first 2 measurements of both observers. Results. In total, 92 images were evaluated using this software. The mean of the standard deviations was 3.87; Cohen's kappa for intra-observer agreement of two observers were 0.947, and 0.943, resp.; Cohen's kappa for inter-observers agreement was 0.880. The agreement between visual and automatic detection of SN pathology was in 97.8% images. The sensitivity, specificity, positive and negative predictive values of automatic measurement were 100, 96.2, 95.1, 100%, resp. Conclusions. The results show very reliable measurement of SN features using designed application with "almost perfect" inter-observer and intra-observer agreements.

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Transcranial brain parenchyma sonography in movement disorders: State of the art

Cited by 221 publications

References 46 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

Brainstem Midline Assessed by Transcranial Sonography in Parkinson's Disease: Further Evidence of a Different Etiopathogenesis of Alexithymia and Depression

A new program for highly reproducible automatic evaluation of the substantia nigra from transcranial sonographic images

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