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Abstract
Transcranial sonography (TCS) in the B-mode has the ability to image, infratentorial and supratentorial brain structures. For this reason, it has potential use in the diagnosis and differential diagnosis of various intracranial pathologies. The authors reviewed the contribution of TCS to the differentiation of a number of neurodegenerative diseases: in parkinsonian syndromes, TCS can evaluate echogenicity changes in specific structures such as the hyperechogenic area of the substantia nigra (SN) in Parkinson's disease and the hyperechogenic caudate nucleus in Huntington's disease as well as the hyperechogenic lentiform nucleus (LN) in dystonia and Wilson's disease. In parkinson-plus syndromes, TCS may detect changes in width of the third ventricle and of the frontal horns of the lateral ventricle. The hyperechogenic SN can also be used in healthy populations as a marker of subclinical injury to the nigrostriatal system. TCS is a quick, safe and non-invasive method. It could be helpful in differentiation between several movement disorders together with clinical examination and other neuroimaging methods.
Highlights
The differentiation between idiopathic Parkinson’s disease (PD) and atypical parkinsonian syndromes can be difficult especially at the beginning of the disease
Transcranial sonography (TCS) evaluation in other movement disorders Studies published so far demonstrate that changes in substantia nigra (SN) echogenicity detected by TCS are not specific for PD, but they are more frequent in other movement disorders than in a healthy population[7, 8, 18]
The results of the pilot studies suggest the ability of TCS to detect accumulation of copper in the basal ganglia preclinically but the results must be confirmed in larger patient population[43]
Summary
The differentiation between idiopathic Parkinson’s disease (PD) and atypical parkinsonian syndromes can be difficult especially at the beginning of the disease. TCS evaluation substantia nigra in Parkinson’s disease In patients with PD, TCS is able to detect a hyperechogenic and enlarged area of the SN as a marker of striatonigral damage. We evaluated the area and echogenicity of SN in 111 patients of PD.
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