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

• Published in: Arquivos de neuro-psiquiatria Vol. 76; no. 7; pp. 459 - 466
• Main Authors: Grippe, Talyta Cortez, Allam, Nasser, Brandão, Pedro Renato de Paula, Pereira, Danilo Assis, Cardoso, Francisco Eduardo Costa, Aguilar, Ana Carolina Rodrigues, Kessler, Iruena Moraes
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Arquivos de Neuro-Psiquiatria 01.07.2018; Academia Brasileira de Neurologia - ABNEURO; Academia Brasileira de Neurologia (ABNEURO)
• Subjects: Basal ganglia; Bayesian analysis; Central nervous system diseases; Diagnosis; diagnostic techniques and procedures; essential tremor; Movement disorders; Neurodegenerative diseases; NEUROSCIENCES; Parkinson's disease; parkinsonian disorders; PSYCHIATRY; Substantia nigra; Tremor; Ultrasonic imaging; ultrasonography; diagnostic techniques and procedures; transtornos parkinsonianos; doença de Parkinson; ultrasonography; tremor essencial; essential tremor; ultrassonografia; técnicas e procedimentos diagnósticos; parkinsonian disorders; Parkinson’s disease
• ISSN: 0004-282X; 1678-4227; 1678-4227
• DOI: 10.1590/0004-282x20180067

Transcranial sonography (TCS) is an emerging ancillary examination for diagnosing Parkinson's disease (PD). To evaluate TCS features in patients with PD and its mimics, and establish their accuracy in predicting the final clinical diagnosis after follow-up. 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. 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. This study revealed the practical usefulness of TCS in differentiating PD from its prevalent mimics when the clinical diagnosis was initially unclear.