Diagnostic Accuracy of Transcranial Sonography of the Substantia Nigra in Parkinson's disease: A Systematic Review and Meta-analysis.

Dun-Hui Li,Ya-Chao He,Jun Liu,Sheng-Di Chen

doi:10.1038/srep20863

Dun-Hui Li, Ya-Chao He + Show 2 more

Open Access

https://doi.org/10.1038/srep20863

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Journal: Scientific reports	Publication Date: Feb 16, 2016
Citations: 49	License type: CC BY 4.0

Affiliation: Ruijin Hospital, Shanghai Jiao Tong University

Abstract

A large number of articles have reported substantia nigra hyperechogenicity in Parkinson’s disease (PD) and have assessed the diagnostic accuracy of transcranial sonography (TCS); however, the conclusions are discrepant. Consequently, this systematic review and meta-analysis aims to consolidate the available observational studies and provide a comprehensive evaluation of the clinical utility of TCS in PD. Totally, 31 studies containing 4,386 participants from 13 countries were included. A random effects model was utilized to pool the effect sizes. Meta-regression and sensitivity analysis were performed to explore potential heterogeneity. Overall diagnostic accuracy of TCS in differentiating PD from normal controls was quite high, with a pooled sensitivity of 0.83 (95% CI: 0.81–0.85) and a pooled specificity of 0.87 (95% CI: 0.85–0.88). The positive likelihood ratio, the negative likelihood ratio and diagnostic odds ratio were calculated 6.94 (95% CI: 5.09–9.48), 0.19 (95% CI: 0.16–0.23), and 42.89 (95% CI: 30.03–61.25) respectively. Our systematic review of the literature and meta-analysis suggest that TCS has high diagnostic accuracy in the diagnosis of PD when compared to healthy control.

Highlights

Have assessed the diagnostic accuracy of transcranial sonography (TCS); the conclusions are discrepant
Our systematic review of the literature and meta-analysis suggest that TCS has high diagnostic accuracy in the diagnosis of Parkinson’s disease (PD) when compared to healthy control
A reliable and convenient test that recapitulates the clinical diagnosis of PD and identifies subclinical PD patients is needed in order to facilitate early disease management and delay or prevent the progression of PD

Summary

Introduction

Have assessed the diagnostic accuracy of transcranial sonography (TCS); the conclusions are discrepant. This systematic review and meta-analysis aims to consolidate the available observational studies and provide a comprehensive evaluation of the clinical utility of TCS in PD. Overall diagnostic accuracy of TCS in differentiating PD from normal controls was quite high, with a pooled sensitivity of 0.83 (95% CI: 0.81–0.85) and a pooled specificity of. Our systematic review of the literature and meta-analysis suggest that TCS has high diagnostic accuracy in the diagnosis of PD when compared to healthy control. Numerous studies have focused on the echogenicity of the SN and the diagnostic accuracy of transcranial sonography (TCS) in distinguishing PD patients from healthy controls, or other movement disorders.

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