Alterations in transcranial sonography among Huntington\u2019s disease patients with psychiatric symptoms

Grzegorz Witkowski,Katarzyna Jachinska,Iwona Stepniak,Halina Sienkiewicz-Jarosz,Karolina Ziora-Jakutowicz

doi:10.1007/s00702-020-02187-x

Grzegorz Witkowski, Katarzyna Jachinska + Show 3 more

Open Access

https://doi.org/10.1007/s00702-020-02187-x

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Abstract

Transcranial sonography (TCS) is a diagnostic tool in mood and movement disorders. Alterations within the raphe mesencephalic nucleus in the brain have been reported not only in patients with major depression but in patients with depressive symptoms accompanying several neurodegenerative disorders. The aim of the study was to assess the echogenicity of the nucleus raphe and other basal ganglia in patients with Huntington’s disease (HD). TCS was performed in 127 HD patients participating in observational studies (Registry/Enroll-HD) in the Institute of Psychiatry and Neurology (Warsaw, Poland). Raphe hypoechogenicity was found in 78% of HD patients with current symptoms of depression (according to DSM-IV criteria), 57% of patients with a previous history of depression, and 56.8% patients who lacked signs or history of depression. Patients with hypoechogenic raphe reported significantly higher depression as measured on the BDI (15.6 ± 1.7) as compared to patients with normal echogenicity (9.5 ± 1.2), (p = 0.023). The diameter of the third ventricle was negatively correlated with Mini-Mental State Examination (MMSE) (rho − 0.37) and total functional capacity (TFC) scores (rho − 0.26). Hyperechogenic substantia nigra was visualized in 66,4% patients with HD and the degree of hyperechogenicity was correlated with the total motor score (TMS) (rho − 0.38). Changes in echogenicity of the basal ganglia are related to both depressive and motor symptoms among patients with HD.

Highlights

In recent years, transcranial sonography (TCS) has been used to visualize structural abnormalities in the brain parenchyma in patients with movement disorders
We used the results of standard assessments performed during annual Registry visits, including UHDRS total motor score (TMS), total functional capacity (TFC), together with Mini-Mental State Examination (MMSE) done as a standard assessment during a patient visit in an outpatient clinic
All Huntington’s disease (HD) patients presented with motor symptoms, with a mean UHDRS TMS score of 37.6

Summary

Introduction

Transcranial sonography (TCS) has been used to visualize structural abnormalities in the brain parenchyma in patients with movement disorders. TCS is a sensitive diagnostic tool in movement disorders, for differential diagnosis of parkinsonian syndromes (Walter et al 2007). Hyperechogenicity of substantia nigra is a characteristic of Parkinson’s disease (PD), wherein atypical parkinsonian syndromes like multiple system atrophy with parkinsonian phenotype (MSA-P) and progressive nuclear palsy (PSP), hyperechogenicity of the lentiform nuclei (LN) is observed more frequently (for recent metaanalysis see Richter et al 2020). Enlarged diameter of the third ventricle is a finding that is more typical for progressive supranuclear palsy (PSP). Both substantia nigra and lentiform nuclei hyperechogenicities are found in Wilson’s disease (Svetel et al 2012). Studies of TCS report changes in the echotexture of serotoninergic mesencephalic raphe nucleus in patients with major depression and depressive symptoms in several

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