Combined assessment by transcranial sonography and Sniffin' Sticks test has a similar diagnostic accuracy compared to brain SPECT for Parkinson's disease diagnosis.

Autor: Almeida KJ; Division of Neurological Surgery, Hospital das Clinicas, University of São Paulo School of Medicine, São Paulo, Brazil. Electronic address: kelsonj@gmail.com., Bor-Seng-Shu E; Division of Neurological Surgery, Hospital das Clinicas, University of São Paulo School of Medicine, São Paulo, Brazil., Pedroso JL; Department of Neurology, Universidade Federal de São Paulo, (UNIFESP - EPM), São Paulo, Brazil., Felicio AC; Department of Neurology, Universidade Federal de São Paulo, (UNIFESP - EPM), São Paulo, Brazil., de-Lima-Oliveira M; Division of Neurological Surgery, Hospital das Clinicas, University of São Paulo School of Medicine, São Paulo, Brazil., Barsottini OGP; Department of Neurology, Universidade Federal de São Paulo, (UNIFESP - EPM), São Paulo, Brazil., de Carvalho Nogueira R; Division of Neurological Surgery, Hospital das Clinicas, University of São Paulo School of Medicine, São Paulo, Brazil., Paschoal-Júnior FM; Division of Neurological Surgery, Hospital das Clinicas, University of São Paulo School of Medicine, São Paulo, Brazil., Borges V; Department of Neurology, Universidade Federal de São Paulo, (UNIFESP - EPM), São Paulo, Brazil., Batista IR; Department of Radiology, Universidade Federal de São Paulo, (UNIFESP - EPM), São Paulo, Brazil., Teixeira MJ; Division of Neurological Surgery, Hospital das Clinicas, University of São Paulo School of Medicine, São Paulo, Brazil., Ferraz HB; Department of Neurology, Universidade Federal de São Paulo, (UNIFESP - EPM), São Paulo, Brazil., Walter U; Department of Neurology, University of Rostock, Rostock, Germany.
Jazyk: angličtina
Zdroj: Clinical neurology and neurosurgery [Clin Neurol Neurosurg] 2022 Sep; Vol. 220, pp. 107333. Date of Electronic Publication: 2022 Jun 11.
DOI: 10.1016/j.clineuro.2022.107333
Abstrakt: Objectives: This study aimed to investigate the accuracy of TCS combined with the Sniffin' sticks olfactory test (SST-16) for differentiation between idiopathic PD patients and healthy controls compared to that of 99 m Tc-TRODAT-1 SPECT (TRODAT).
Methods: A cross-sectional study included PD patients diagnosed in accordance with United Kingdom PD Society Brain Bank criteria and a control group of age and sex- matched healthy subjects. All patients were examined by a movement disorder specialist and underwent brain SPECT using TRODAT, TCS examination and SST-16 test. Receiver Operating Characteristic (ROC) curves were used to calculate cut-off points for TCS, striatal TRODAT binding potentials and SST-16. The area under the ROC curve determined the diagnostic accuracy of the method.
Results: Twenty patients with PD (13 males and 7 females) and nine healthy subjects were included. Median age of PD onset was 56.5 years with median disease duration of 5 years. A larger substantia nigra (SN) echogenic area was observed in the PD group (p = 0.013). SN echogenic area cut-off point of 0.22 cm 2 was obtained from a ROC curve for PD diagnosis. Considering this cut-off point, TCS diagnostic accuracy was estimated at 79.2% for PD diagnosis. The cut-off value of 0.90 for striatal TRODAT binding was associated with 99% diagnostic accuracy for the diagnosis of PD. SST-16 values equal or less than 9 points showed an 85.8% diagnostic accuracy for PD diagnosis. Combination of both SST-16 and TCS improved the diagnostic accuracy to 95% for PD diagnosis.
Conclusion: Combined SST-16 and TCS assessment was indicated as accurate for distinguishing PD patients from healthy controls. The diagnostic accuracy of TCS combined with SST-16 for differentiation between idiopathic PD patients and healthy controls is similar to that of SPECT TRODAT.
Competing Interests: Declarations of interest None.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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