Transcranial sonography and the pocket smell test in the differential diagnosis between parkinson’s disease and essential tremor

Bradvica, Ivanka Štenc; Mihaljević, Ivan; Butković-Soldo, Silva; Kadojić, Dragutin; Titlić, Marina; Bradvica, Mario; Kralik, Kristina

doi:10.1007/s10072-015-2152-y

Cited by 18 publications

(20 citation statements)

References 37 publications

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“…TCS is a noninvasive ultrasound imaging method that is being developed for structural imaging of some brain regions in PD and has potential use in the clinical diagnosis of PD (Alonso-Canovas et al, 2014; Bouwmans et al, 2013; Mehnert et al, 2010; Politis, 2014; Sahuquillo et al, 2013; Stenc et al, 2015). Most TCS studies of PD have focused on echogenicity of the substantia nigra, but other brain regions have also been assessed, such as the lenticular nucleus, raphe nuclei, and ventricles.…”

Section: Neuroimaging Methodsmentioning

confidence: 99%

Neuroimaging of Parkinson's disease: Expanding views

Weingarten

Sundman

Hickey

et al. 2015

Neuroscience & Biobehavioral Reviews

130

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Advances in molecular and structural and functional neuroimaging are rapidly expanding the complexity of neurobiological understanding of Parkinson’s disease (PD). This review article begins with an introduction to PD neurobiology as a foundation for interpreting neuroimaging findings that may further lead to more integrated and comprehensive understanding of PD. Diverse areas of PD neuroimaging are then reviewed and summarized, including positron emission tomography, single photon emission computed tomography, magnetic resonance spectroscopy and imaging, transcranial sonography, magnetoencephalography, and multimodal imaging, with focus on human studies published over the last five years. These included studies on differential diagnosis, co-morbidity, genetic and prodromal PD, and treatments from L-DOPA to brain stimulation approaches, transplantation and gene therapies. Overall, neuroimaging has shown that PD is a neurodegenerative disorder involving many neurotransmitters, brain regions, structural and functional connections, and neurocognitive systems. A broad neurobiological understanding of PD will be essential for translational efforts to develop better treatments and preventive strategies. Many questions remain and we conclude with some suggestions for future directions of neuroimaging of PD.

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Section: Neuroimaging Methodsmentioning

confidence: 99%

Neuroimaging of Parkinson's disease: Expanding views

Weingarten

Sundman

Hickey

et al. 2015

Neuroscience & Biobehavioral Reviews

130

View full text Add to dashboard Cite

show abstract

“…As a noninvasive technique, transcranial sonography (TCS) is potentially useful for the diagnosis of PD by showing the structural changes in substantia nigra (SN). Even though previous studies have proved that the specificity was 88.2-85% and the sensitivity was 84-94.9% in diagnostic accuracy of TCS in PD patients [3,4], and the concordance rate between TCS patterns and PD diagnosis increased from 87 to 95% in a 4year follow-up [5]. Still, the data based on Chinese population need to be supplemented.…”

Section: Introductionmentioning

confidence: 92%

Increased substantia nigra echogenicity correlated with visual hallucinations in Parkinson’s disease: a Chinese population-based study

Shi

Qin

et al. 2019

Neurol Sci

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As a noninvasive technique, transcranial sonography (TCS) of substantia nigra (SN) has gradually showed its effectiveness not only in diagnosis but also in understanding clinical features of Parkinson's Disease (PD). This study aimed to further evaluate TCS for clinical diagnosis of PD, and to explore the association between sonographic manifestations and visual hallucinations (VH). A total of 226 subjects including 141 PD patients and 85 controls were recruited. All participants received TCS. A series of rating scales to evaluate motor and non-motor symptoms were performed in PD patients. Results showed that 172 subjects were successfully assessed by TCS. The area of SN was greater in PD patients than that in controls (P < 0.001). As receiver-operating characteristic (ROC) curve analysis showed, the best cutoff value for the larger SN echogenicity size was 23.5 mm 2 (sensitivity 70.3%, specificity 77.0%). Patients with VH had larger SN area (P = 0.019), as well as higher Non-Motor Symptoms Scale (NMSS) scores (P = 0.018). Moreover, binary logistic regression analysis indicated that SN hyperechogenicity (odds ratio = 4.227, P = 0.012) and NMSS scores (odds ratio = 0.027, P = 0.042) could be the independent predictors for VH. In conclusion, TCS can be used as an auxiliary diagnostic tool for Parkinson's disease. Increased SN echogenicity is correlated with VH in Parkinson's disease, possibly because the brain stem is involved in the mechanism in the onset of VH. Further studies are needed to confirm these findings.

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“…Nevertheless, the sensitivity and specificity of TCS in PD varied widely due to racial differences, sample size and diverse ultrasound devices. In a cross-sectional study conducted in Italy, using a 2–4 MHz probe, researchers found the sensitivity and specificity of TCS in diagnosing PD to be 62.71% and 76.92%, respectively 4 , while the value reported by Maria Sierria et al was 95.50% and 84.78%, respectively 5 . Unfortunately, the lack of a comprehensive evaluation of the clinical utility of TCS has prevented the application of this non-invasive, non-radioactive and convenient technique in routine clinical practice.…”

mentioning

confidence: 91%

Diagnostic Accuracy of Transcranial Sonography of the Substantia Nigra in Parkinson’s disease: A Systematic Review and Meta-analysis

et al. 2016

Sci Rep

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A large number of articles have reported substantia nigra hyperechogenicity in Parkinson’s disease (PD) and have assessed the diagnostic accuracy of transcranial sonography (TCS); however, the conclusions are discrepant. Consequently, this systematic review and meta-analysis aims to consolidate the available observational studies and provide a comprehensive evaluation of the clinical utility of TCS in PD. Totally, 31 studies containing 4,386 participants from 13 countries were included. A random effects model was utilized to pool the effect sizes. Meta-regression and sensitivity analysis were performed to explore potential heterogeneity. Overall diagnostic accuracy of TCS in differentiating PD from normal controls was quite high, with a pooled sensitivity of 0.83 (95% CI: 0.81–0.85) and a pooled specificity of 0.87 (95% CI: 0.85–0.88). The positive likelihood ratio, the negative likelihood ratio and diagnostic odds ratio were calculated 6.94 (95% CI: 5.09–9.48), 0.19 (95% CI: 0.16–0.23), and 42.89 (95% CI: 30.03–61.25) respectively. Our systematic review of the literature and meta-analysis suggest that TCS has high diagnostic accuracy in the diagnosis of PD when compared to healthy control.

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Transcranial sonography and the pocket smell test in the differential diagnosis between parkinson’s disease and essential tremor

Cited by 18 publications

References 37 publications

Neuroimaging of Parkinson's disease: Expanding views

Neuroimaging of Parkinson's disease: Expanding views

Increased substantia nigra echogenicity correlated with visual hallucinations in Parkinson’s disease: a Chinese population-based study

Diagnostic Accuracy of Transcranial Sonography of the Substantia Nigra in Parkinson’s disease: A Systematic Review and Meta-analysis

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