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Mesencephalic area measured by transcranial sonography in the differential diagnosis of parkinsonism.
MedLine Citation:
PMID:  23684370     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Transcranial B-mode sonography (TCS) has become an important tool in the differential diagnosis of parkinsonism given that current technology enables an adequate assessment of brain structures. In this study we aimed at evaluating the usefulness of midbrain area measured by TCS in the differential diagnosis between Parkinson's Disease (PD) and Progressive Supranuclear Palsy (PSP). METHODS: Patients with a diagnosis of PD or PSP according to current clinical criteria were recruited. PSP patients were classified as Richardson's syndrome and PSP-parkinsonism. TCS was performed and the mesencephalic area and third ventricle width were measured offline by an examiner blinded to clinical diagnosis. RESULTS: TCS was performed in 60 patients (75% PD, 25% PSP). Eight patients (13,3%) had inadequate acoustic window. Patients with PSP had a smaller mesencephalic area (3.58 cm(2) vs 5.28 cm(2), p < 0.001). A mesencephalic area ≥4.27 cm(2) discriminates PD from PSP with a positive predictive value 100%. Patients with PSP also had a higher third ventricle diameter (8.84 mm vs 5.11 mm, p < 0.001). Within the PSP group patients with Richardson's syndrome had a wider third ventricle than patients with PSP-Parkinsonism phenotype (9.57 mm vs 7 mm, p = 0.01), but no differences were found in the mesencephalic area between both phenotypes. CONCLUSIONS: Measurement of the mesencephalic area and the third ventricle width by TCS is a non-invasive, easily accessible technique that is useful in the differential diagnosis between PD and PSP, at least in the late stages of the disease.
Authors:
Isabel Sastre-Bataller; Juan Francisco Vázquez; Irene Martínez-Torres; Patricia Sahuquillo; Ignacio Rubio-Agustí; Juan Andrés Burguera; Jose Manuel Ferrer; Caridad Valero; Jose Ignacio Tembl
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-5-14
Journal Detail:
Title:  Parkinsonism & related disorders     Volume:  -     ISSN:  1873-5126     ISO Abbreviation:  Parkinsonism Relat. Disord.     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-5-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9513583     Medline TA:  Parkinsonism Relat Disord     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Elsevier Ltd. All rights reserved.
Affiliation:
Department of Neurology, Hospital Universitari i Politècnic la Fe, Valencia, Spain. Electronic address: isa.sastre99@gmail.com.
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