Transcranial sonography in atypical parkinsonism: How reliable is it in real clinical practice? A multicentre comprehensive study

Autor: Irene Martinez-Torres, Jaime Masjuan, Paula Pérez-Torre, Juan Carlos Martínez-Castrillo, Isabel Parees-Moreno, Enric Monreal-Laguillo, Uwe Walter, Araceli Alonso-Canovas, Rafael Toledano Delgado, José Ignacio Tembl Ferrairó, Jose Luis López-Sendón Moreno, Isabel Sastre Bataller, Guillermo García Ribas
Rok vydání: 2019
Předmět:
0301 basic medicine
Male
medicine.medical_specialty
diagnostic imaging [Corpus Striatum]
Parkinson's disease
Ultrasonography
Doppler
Transcranial
Gastroenterology
Sensitivity and Specificity
Progressive supranuclear palsy
03 medical and health sciences
0302 clinical medicine
Atrophy
Parkinsonian Disorders
Internal medicine
diagnostic imaging [Substantia Nigra]
medicine
standards [Ultrasonography
Doppler
Transcranial]
Corticobasal degeneration
Humans
ddc:610
diagnostic imaging [Third Ventricle]
Aged
Third Ventricle
Aged
80 and over
Lenticular nucleus
business.industry
Reproducibility of Results
Middle Aged
diagnostic imaging [Parkinsonian Disorders]
medicine.disease
Control subjects
Corpus Striatum
Clinical Practice
Substantia Nigra
030104 developmental biology
Neurology
Atypical Parkinsonism
Female
Neurology (clinical)
Geriatrics and Gerontology
business
030217 neurology & neurosurgery
Zdroj: Parkinsonism & related disorders 68, 40-45 (2019). doi:10.1016/j.parkreldis.2019.09.032
ISSN: 1873-5126
Popis: Introduction 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. Methods 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. Results 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). Conclusions 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.
Databáze: OpenAIRE
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