Journal Article

DZNE-2020-07908

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Transcranial sonography in atypical parkinsonism: How reliable is it in real clinical practice? A multicentre comprehensive study.

Alonso-Canovas, A. (Corresponding author) ; Tembl Ferrairó, J. I. ; Martínez-Torres, I. ; Lopez-Sendon Moreno, J. L. ; Parees-Moreno, I. ; Monreal-Laguillo, E. ; Pérez-Torre, P. ; Toledano Delgado, R. ; García Ribas, G. ; Sastre Bataller, I. ; Masjuan, J. ; Martinez-Castrillo, J. C. ; Walter, U. (Last author)DZNE*

2019
Elsevier Science Amsterdam [u.a.]

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Please use a persistent id in citations: doi:10.1016/j.parkreldis.2019.09.032

Abstract: Substantia nigra hyperechogenicity (SN+) in transcranial sonography (TCS) is frequent in Parkinson's disease (PD), while lenticular nucleus hyperechogenicity (LN+) and 3rd ventricle enlargement (3V+) are typical of Atypical Parkinsonisms (AP). However, there are no studies assessing the diagnostic yield of all TCS biomarkers in the three AP (progressive supranuclear palsy, PSP, multiple system atrophy, MSA, corticobasal degeneration, CBD). Previous references lack homogeneous criteria and data are incomprehensive.Analysis of TCS performed in routine clinical practice in AP and PD patients from two tertiary hospitals. Expert recommendations were strictly followed. Previous literature was critically analysed.155 AP (98 PSP, 40 MSA, 14 CBD), 254 PD, 145 control subjects were included. We confirmed good sensitivity for SN+ in PD (80%), but specificity was lower than reported (61%). LN+ and 3V + had moderate sensitivity for AP and PSP diagnosis respectively (65%, 63%), but specificity was higher than reported (87%, 91%). We confirmed high specificity and positive predictive value of the combination SN/LN (98%, 93% AP; 83%, 86% PD). The combinations of two or three echofeatures, previously unreported, showed high specificity but lower sensitivity (SN/3V: 75% sensitivity, 87% specificity PD; 42% sensitivity, 98% specificity PSP) (SN + LN+: 79% sensitivity, 86% specificity CBD) (SN/3V/LN: 67% sensitivity, 89% specificity PD; 29% sensitivity, 99% specificity PSP; 41% sensitivity, 95% specificity MSA; 57% sensitivity 91% specificity CBD).We present a large comprehensive study of TCS, confirming its usefulness and certain limitations in AP diagnosis. Adherence to consensus criteria is critical to implement TCS for clinical and research purposes.

Keyword(s): Aged (MeSH) ; Aged, 80 and over (MeSH) ; Corpus Striatum: diagnostic imaging (MeSH) ; Female (MeSH) ; Humans (MeSH) ; Male (MeSH) ; Middle Aged (MeSH) ; Parkinsonian Disorders: diagnostic imaging (MeSH) ; Reproducibility of Results (MeSH) ; Sensitivity and Specificity (MeSH) ; Substantia Nigra: diagnostic imaging (MeSH) ; Third Ventricle: diagnostic imaging (MeSH) ; Ultrasonography, Doppler, Transcranial: standards (MeSH)

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Contributing Institute(s):

1. Rostock / Greifswald common (Rostock / Greifswald common)

Research Program(s):

1. 344 - Clinical and Health Care Research (POF3-344) (POF3-344)

Appears in the scientific report 2019

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Database coverage:
; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Ebsco Academic Search ; IF < 5 ; JCR ; SCOPUS ; Web of Science Core Collection

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