Is transcranial sonography useful for diagnosing Parkinson's disease in clinical practice?

Arq Neuropsiquiatr. 2018 Jul;76(7):459-466. doi: 10.1590/0004-282X20180067.

Abstract

Objective: Transcranial sonography (TCS) is an emerging ancillary examination for diagnosing Parkinson's disease (PD).

Objective: To evaluate TCS features in patients with PD and its mimics, and establish their accuracy in predicting the final clinical diagnosis after follow-up.

Methods: We retrospectively studied 85 patients with an initial clinical suspicion of PD, atypical parkinsonism or essential tremor, all of whom underwent TCS. Two specialists reviewed the follow-up clinical visit records and determined the final clinical diagnosis. The accuracy analysis of the TCS was determined using Bayesian statistical methods.

Results: The finding of substantia nigra hyperechogenicity (> 20 mm2) showed high sensitivity (93.4%) and specificity (86.6%). The positive likelihood ratio showed 6.93-fold greater odds for diagnosing PD than an alternative condition when this finding was present.

Conclusions: This study revealed the practical usefulness of TCS in differentiating PD from its prevalent mimics when the clinical diagnosis was initially unclear.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / diagnostic imaging*
  • ROC Curve
  • Retrospective Studies
  • Sensitivity and Specificity
  • Ultrasonography, Doppler, Transcranial*
  • Young Adult