Document Detail


Sonographic discrimination of dementia with Lewy bodies and Parkinson's disease with dementia.
MedLine Citation:
PMID:  16267638     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To study the use of transcranial sonography (TCS) in discriminating between patients with dementia with Lewy bodies (DLB) and Parkinson's disease with dementia (PDD). METHODS: Fourteen patients with DLB, 31 with PDD and 73 with PD without dementia (PDnD) were studied with TCS. RESULTS: All assessable patients with DLB, 97% with PDD, and 94% with PDnD showed at least unilateral hyperechogenicity of substantia nigra (SN). However, bilateral marked SN hyperechogenicity was present in 80% of DLB patients but only in one third of PDD and PDnD patients, and was associated with younger age at disease onset in PD but not in DLB. An asymmetry index > or = 1.15 of bilateral SN echogenic sizes, estimated by division of larger size by smaller size, was found in 69% of PDD patients but only 20% of DLB patients. Combination of SN echogenic sizes, asymmetry indices and onset age discriminated PDD from DLB with a sensitivity of 96%, a specificity of 80% and a positive predictive value of 93%. TCS of brainstem raphe, thalami, lenticular nuclei, caudate nuclei and ventricle widths did not discriminate between DLB and PDD. Compared with PDnD patients, DLB and PDD patients exhibited significantly larger widths of third ventricle and of frontal horns. In PDD patients, scores on the Unified Parkinson's Disease Rating Scale correlated with widths of third ventricle and of frontal horns. CONCLUSIONS: SN hyperechogenicity is typical for PDD and DLB. However, size, asymmetry and relation of SN hyperechogenicity to age at disease onset discriminate PDD from DLB.
Authors:
Uwe Walter; Dirk Dressler; Alexander Wolters; Matthias Wittstock; Brigitte Greim; Reiner Benecke
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Publication Detail:
Type:  Journal Article     Date:  2005-11-04
Journal Detail:
Title:  Journal of neurology     Volume:  253     ISSN:  0340-5354     ISO Abbreviation:  J. Neurol.     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-05-11     Completed Date:  2007-04-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0423161     Medline TA:  J Neurol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  448-54     Citation Subset:  IM    
Affiliation:
Dept. of Neurology, University of Rostock, Gehlsheimer Str. 20, 18147, Rostock, Germany. uwe.walter@med.uni-rostock.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Basal Ganglia / ultrasonography
Cerebral Ventricles / ultrasonography
Dementia / etiology,  ultrasonography*
Diagnosis, Differential
Female
Humans
Lewy Body Disease / ultrasonography*
Male
Mesencephalon / ultrasonography
Middle Aged
Neuropsychological Tests
Parkinson Disease / complications,  ultrasonography*
Reproducibility of Results
Substantia Nigra / ultrasonography
Ultrasonography, Doppler, Transcranial

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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