Transcranial midbrain sonography and depressive symptoms in patients with Parkinson’s disease

Stanković, Iva; Stefanova, Elka; Ziropadja, Ljubomir; Mijajlović, Milija; Pavlović, Aleksandra M.; Kostić, Vladimir

doi:10.1007/s00415-014-7624-0

Cited by 14 publications

(21 citation statements)

References 51 publications

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“…Considering also the slightly reduced BR echogenicity, an abnormal finding was detected even in 91% of the depressed patients. Stankovic et al studied a cohort of 118 PD patients and also found higher frequency of BR hypoechogenicity among depressed than in nondepressed PD patients (59% vs. 33%, respectively) . According to their findings, hypoechogenic BR was associated with a 3.5 times increased risk of developing depression .…”

Section: Tcs In Depressed Patients With Association To Neurodegeneratmentioning

confidence: 95%

“…Stankovic et al studied a cohort of 118 PD patients and also found higher frequency of BR hypoechogenicity among depressed than in nondepressed PD patients (59% vs. 33%, respectively). 39 According to their findings, hypoechogenic BR was associated with a 3.5 times increased risk of developing depression. 39 Zhang et al found BR hypoechogenicity in 34 (85%) of 40 depressed but only 4 (10%) of 40 nondepressed PD patients.…”

Section: Tcs In Depressed Patients With Association To Neurodegeneratmentioning

confidence: 98%

“…39 According to their findings, hypoechogenic BR was associated with a 3.5 times increased risk of developing depression. 39 Zhang et al found BR hypoechogenicity in 34 (85%) of 40 depressed but only 4 (10%) of 40 nondepressed PD patients. 40 In idiopathic REM sleep behavior disorder (iRBD), a disorder with high liability of subsequent development of PD, also an increased frequency of BR hypoechogenicity in depressed subjects was found.…”

Section: Tcs In Depressed Patients With Association To Neurodegeneratmentioning

confidence: 98%

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Transcranial Sonography Findings in Depression in Association With Psychiatric and Neurologic Diseases: A Review

Krogias

Walter

2016

Journal of Neuroimaging

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The transcranial sonography (TCS) finding of reduced echogenicity of brainstem raphe (hypoechogenic BR) has been associated with depressive states. Here, we review the TCS studies in subjects with depressive disorders and with depression related to degenerative brain diseases, and compare the frequency and clinical correlates of hypoechogenic BR in these reports. Summarizing the data published so far, hypoechogenic BR is present in 67% (range, 37-95%) of depressed but only in 15% (5-36%) of nondepressed subjects without history of neurodegenerative disease. The finding of hypoechogenic BR in these subjects is associated with a relative risk of 3.03 (95% CI, 2.44-3.75; P < .001) of being diagnosed with depression. In patients with Parkinson's disease, hypoechogenic BR is present in 63% (35-92%) of depressed but only in 27% (10-62%) of nondepressed patients, resulting in a relative risk of 2.18 (95% CI, 1.80-2.66; P < .001) of being diagnosed with depression. Hypoechogenic BR is associated with depression in a number of neurological disorders such Huntington's disease, idiopathic Rapid Eye Movement (REM) sleep behavior disorder, myotonic dystrophies, and cerebral small vessel disease. Although some studies did not show any relationship between BR echogenicity and severity of depression, others suggest an association with higher severity of depression, or even with suicidal ideation. In one study BR hypoechogenicity was found to be associated with better responsivity to serotonin reuptake inhibitors. Further studies are warranted to compare the TCS findings of BR alteration with post-mortem histopathological findings, and with genetic variants related to cerebral serotonin metabolism.

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Section: Tcs In Depressed Patients With Association To Neurodegeneratmentioning

confidence: 95%

Section: Tcs In Depressed Patients With Association To Neurodegeneratmentioning

confidence: 98%

Section: Tcs In Depressed Patients With Association To Neurodegeneratmentioning

confidence: 98%

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Transcranial Sonography Findings in Depression in Association With Psychiatric and Neurologic Diseases: A Review

Krogias

Walter

2016

Journal of Neuroimaging

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“…Grade 0 and grade 1 are classified as hypoechogenic. Continuous echogenicity of the raphe is the normal finding in the general population [8][9][10]. Neuropsychological tests and TCS were performed and analysed in different settings and by examiners blind to diagnosis of depression/alexithymia.…”

Section: Methodsmentioning

confidence: 99%

“…Reduced echogenicity of midbrain raphe, evaluated with TCS, is a characteristic finding in depression associated with PD [7][8][9][10]. No data are available on brainstem's echogenicity in alexithymic patients.…”

Section: Introductionmentioning

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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Transcranial sonography image characteristics in different Parkinson’s disease subtypes

et al. 2017

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Recently, Parkinson's disease (PD) has been classified into three subtypes: postural instability gait difficulty (PIGD), tremor dominate (TD), and indeterminate PD. Transcranial sonography (TCS) is considered to be an important tool to diagnose PD. However, it is uncertain that whether there are differences in TCS image characteristics in different PD subtypes, so 373 idiopathic PD (188 PIGD, 108 TD, 77 indeterminate PD) were registered and received TCS in our investigation; also, the association between clinical characteristics and TCS results in different PD subtypes was analyzed. In accordance with several previous studies, we detected substantia nigra (SN) by TCS in 85.4% of patients with idiopathic PD; we concluded that PIGD patients had more serious disease than TD and indeterminate PD group (p < 0.05). They always had larger SN hyperechogenicity areas on TCS (p < 0.05), and we found that there was no correlation between SN hyperechogenicity and disease duration or severity (p > 0.05). Similarly, abnormal brainstem raphe signal was also more often in PIGD group than in TD and indeterminate PD group (p < 0.05), which might imply that PIGD group was vulnerable to suffer from depression in the future.

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Transcranial midbrain sonography and depressive symptoms in patients with Parkinson’s disease

Cited by 14 publications

References 51 publications

Transcranial Sonography Findings in Depression in Association With Psychiatric and Neurologic Diseases: A Review

Transcranial Sonography Findings in Depression in Association With Psychiatric and Neurologic Diseases: A Review

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

Transcranial sonography image characteristics in different Parkinson’s disease subtypes

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