engleski

Transcranial sonography in movement disorders

Background: So far, there is no reliable test that can clearly distinguish between various movement disorders. Therefore, the diagnosis is still based on the clinical examination. However, the misdiagnosis rate for the most common movement disorders – Parkinson’ s disease (PD) and Essential tremor (ET) – in the early stages is as high as 20– 30% for PD and in about one of three patients in ET.We initiated these studies to assess the possibility of Transcranial sonography (TCS) to help differentiate PD from ET by measuring echogenicity of the substantia nigra (SN). Patients and methods: Our study included 60 patients with PD, 30 patients with ET and 60 healthy controls. The TCS recordings were done in axial plane by standardized protocol by two independent investigators. SN was displayed, encircled, and measured two times. Mean area was calculated. Mann Whitney U test for intergroup comparison was applied. Results: Patients with ET and PD had mean SN size of 0.15 cm2 (± ; 0.04) and 0.27cm2 (± ; 0.06), which showed significant difference (p<0.001). In the control group bilateral combined mean SN size was 0.17cm2 (± ; 0.06), which was significantly different from PD group (p<0.001), but not from ET group (p=0.240). Conclusion: The measurement of SN by means of TCS is a valuable tool in the differentiation of movement disorders. Due to portability, lack of invasiveness and easiness of reproducibility, TCS might help in diagnosing PD or in differential diagnosis of doubtful clinical cases.

Transcranial sonography ; movement disorders ; Parkinson's disease ; substantia nigra

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