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@ARTICLE{AlonsoCanovas:141584,
      author       = {Alonso-Canovas, Araceli and Tembl Ferrairó, José Ignacio
                      and Martínez-Torres, Irene and Lopez-Sendon Moreno, Jose
                      Luis and Parees-Moreno, Isabel and Monreal-Laguillo, Enric
                      and Pérez-Torre, Paula and Toledano Delgado, Rafael and
                      García Ribas, Guillermo and Sastre Bataller, Isabel and
                      Masjuan, Jaime and Martinez-Castrillo, Juan Carlos and
                      Walter, Uwe},
      title        = {{T}ranscranial sonography in atypical parkinsonism: {H}ow
                      reliable is it in real clinical practice? {A} multicentre
                      comprehensive study.},
      journal      = {Parkinsonism $\&$ related disorders},
      volume       = {68},
      issn         = {1353-8020},
      address      = {Amsterdam [u.a.]},
      publisher    = {Elsevier Science},
      reportid     = {DZNE-2020-07908},
      pages        = {40-45},
      year         = {2019},
      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.},
      keywords     = {Aged / Aged, 80 and over / Corpus Striatum: diagnostic
                      imaging / Female / Humans / Male / Middle Aged /
                      Parkinsonian Disorders: diagnostic imaging / Reproducibility
                      of Results / Sensitivity and Specificity / Substantia Nigra:
                      diagnostic imaging / Third Ventricle: diagnostic imaging /
                      Ultrasonography, Doppler, Transcranial: standards},
      cin          = {Rostock / Greifswald common},
      ddc          = {610},
      cid          = {I:(DE-2719)6000017},
      pnm          = {344 - Clinical and Health Care Research (POF3-344)},
      pid          = {G:(DE-HGF)POF3-344},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:31621617},
      doi          = {10.1016/j.parkreldis.2019.09.032},
      url          = {https://pub.dzne.de/record/141584},
}