Basal ganglia echogenicity in tauopathies.

Krzysztof Sadowski,Andrzej Friedman,Karol Szlachta,Małgorzata Serafin-Król

doi:10.1007/s00702-014-1310-3

Abstract

Accumulating data confirm the usefulness of transcranial sonography (TCS) in the diagnosis of Parkinson’s disease. The relevance of basal ganglia abnormalities depicted by TCS in atypical parkinsonian syndromes still needs further assessment. In the present study, 20 patients with progressive supranuclear palsy (PSP) and 13 patients with corticobasal syndrome (CBS) were studied with the use of transcranial sonography. Echogenicity of the substantia nigra (SN) and lenticular nucleus (LN) were assessed. 0/20 patients with PSP and 8/12 (66.6 %) patients with CBS were characterized with SN hyperechogenicity. LN hyperechogenicity was observed in 9/20 patients diagnosed with PSP and 0/11 of CBS patients. The combination of SN isoechogenicity and LN hyperechogenicity reached 100 % sensitivity and positive predictive value for the diagnosis of PSP. The results of this study point out that CBS has to be taken into consideration when SN hyperechogenicity is depicted in a patient with parkinsonian syndrome. Normal echogenicity of the SN coexisting with LN hyperechogenicity practically excludes CBS.

Highlights

Accumulating data confirm the usefulness of transcranial sonography (TCS) in the diagnosis of Parkinson’s disease
The results of this study confirm the relatively high occurrence of substantia nigra (SN) hyperechogenicity in patients diagnosed with corticobasal syndrome (CBS) distinguishing them from other patients with atypical parkinsonian syndromes
The fact that SN hyperechogenicity is a frequent finding in CBS patients has to be taken seriously into consideration, especially in the context of the specificity of this finding in Parkinson‘s disease (PD) patients

Summary

Introduction

Accumulating data confirm the usefulness of transcranial sonography (TCS) in the diagnosis of Parkinson’s disease. 20 patients with progressive supranuclear palsy (PSP) and 13 patients with corticobasal syndrome (CBS) were studied with the use of transcranial sonography. According to available data (Walter et al 2003; Behnke et al 2005) 6–25 % of patients with multiple system atrophy (MSA) are characterized by SN hyperechogenicity, whereas in patients diagnosed with progressive supranuclear palsy (PSP) this echo feature is observed in 8–47 %. To date there is only one published study (Walter et al 2004) describing TCS findings in merely 8 patients diagnosed with corticobasal syndrome (CBS). 0.1 assessment was applied to patients with two types of tauopathies—PSP and CBS—to evaluate the clinical usefulness of TCS as a supporting tool in the diagnosis of these conditions

Methods

Findings

Conclusion