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000283119 1001_ $$aStiehm, M.$$b0
000283119 245__ $$aThe diagnostic value of transcranial sonography in Swedish parkinsonism patients: A retrospective cohort study with long-term follow-up.
000283119 260__ $$aAmsterdam$$bElsevier$$c2025
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000283119 520__ $$aAlthough transcranial sonography (TCS) assessing hyperechogenic substantia nigra (SN+) as biomarker for Parkinsońs disease (PD) has been introduced elsewhere, the clinical relevance and accuracy in a Swedish population is still unknown.This retrospective single-center study included 74 patients with predominantly early-stage parkinsonism at first visit who had been examined by TCS from 2013 to 2017 to determine the SN+ biomarker status in relation to PD, atypical parkinsonian disorders (APS), essential tremor (ET) and vascular/secondary/ unspecified parkinsonism, with the aim of long-term follow-up to confirm the clinical diagnosis. The cut-off value for SN+ was regarded as the 90 % percentile of SN echogenicity in a local healthy cohort (here, 0.23 cm2).In 2024, the mean follow-up time was 95 months. Three patients (4 %) without transcranial bone were excluded. SN+ was found in 38/51 patients with finally diagnosed PD and 4/20 patients with other final clinical diagnoses (p < 0.001). Sensitivity was moderate (75 %) whereas specificity and the positive predictive value were higher (80 % and 90 %, respectively). SN area measurements (most abnormal side) were significantly different in PD-patients compared to non-PD patients (n = 63; 0.28 ± 0.09 [95 % CI: 0.25-0.30] cm2 vs. 0.23 ± 0.10 [0.18-0.29] cm2, p 0.035).After a follow-up of up to 8 years, to maximize diagnostic certainty, our findings support the use of TCS as a valuable add-on tool in PD diagnostics in a Swedish patient population, already in the early stage of disease but not for screening.
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000283119 650_7 $$2Other$$aEssential tremor
000283119 650_7 $$2Other$$aHyperechogenicity
000283119 650_7 $$2Other$$aMovement disorders
000283119 650_7 $$2Other$$aParkinsonism
000283119 650_7 $$2Other$$aParkinsońs disease
000283119 650_7 $$2Other$$aSubstantia nigra
000283119 650_7 $$2Other$$aTranscranial sonography
000283119 650_7 $$2Other$$aUltrasound
000283119 7001_ $$aNilsson, C.$$b1
000283119 7001_ $$aSkogar, Ö$$b2
000283119 7001_ $$0P:(DE-2719)9000336$$aWalter, U.$$b3$$eLast author$$udzne
000283119 773__ $$0PERI:(DE-600)3003034-1$$a10.1016/j.prdoa.2025.100411$$gVol. 13, p. 100411 -$$p100411$$tClinical parkinsonism & related disorders$$v13$$x2590-1125$$y2025
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