Objectives-Hyperechogenicity of the substantia nigra on transcranial sonography is used for diagnosing Parkinson disease (PD). Cutoff values for the substantia nigra echogenic area, defining substantia nigra hyperechogenicity, vary among ultrasound systems from different manufacturers. In this study we wanted to determine the cutoff criterion for a Toshiba (Tokyo, Japan) system and to assess its diagnostic value. Methods Three hundred participants (controls, n = 138; patients with PD, n = 105; and patients with essential tremor, n = 57) underwent transcranial sonography following a standardized protocol. Results The substantia nigra was assessable in 92.7% of all participants. The substantia nigra echogenic area (larger of bilateral measurements) was larger in patients with PD (mean +/- SD, 0.24 +/- 0.05 cm(2)) than controls (0.14 +/- 0.05 cm(2); P < .001) and patients with essential tremor (0.14 +/- 0.04 cm(2); P < .001). Substantia nigra echogenicity was larger in male participants (0.20 +/- 0.07 cm(2)) than female participants (0.15 +/- 0.06 cm(2); P < .001). Age did not correlate with substantia nigra echogenicity in any group. Frontal horn width was larger and lenticular nucleus hyperechogenicity and a discontinuous raphe were more frequent in the PD group than the other groups. On multivariate analysis, only substantia nigra hyperechogenicity was associated with the diagnosis of PD. The 90th-percentile substantia nigra echogenic area in the control group, which defined marked substantia nigra hyperechogenicity, also represented the optimum cutoff value for discrimination of PD from non-PD participants on receiver operating characteristic curve analysis (area under the curve, 0.913; Youden index, 0.73). This cutoff value (>= 0.21 cm(2), larger of bilateral measurements) yielded sensitivity of 83% and specificity of 90% for the diagnosis of PD. Conclusions-Transcranial sonography shows good diagnostic validity for diagnosis of PD when implemented according to a strictly standardized protocol.
机构:
Univ Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Univ Roma La Sapienza, IRCCS NEUROMED Inst, I-00185 Rome, ItalyUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Berardelli, A.
Wenning, G. K.
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Med Univ Innsbruck, Dept Neurol, A-6020 Innsbruck, AustriaUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Wenning, G. K.
Antonini, A.
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h-index: 0
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Parkinsons Dis & Movement Disorders Unit IRCCS, Milan, ItalyUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Antonini, A.
Berg, D.
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h-index: 0
机构:
Univ Tubingen, Dept Neurodegenerat Dis, Hertie Inst Clin Brain Res, German Ctr Neurodegenerat Dis, Tubingen, Germany
DZNE, Tubingen, GermanyUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Berg, D.
Bloem, B. R.
论文数: 0引用数: 0
h-index: 0
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Radboud Univ Nijmegen, Med Ctr, Dept Neurol, Donders Inst Brain Cognit & Behav, NL-6525 ED Nijmegen, NetherlandsUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Bloem, B. R.
Bonifati, V.
论文数: 0引用数: 0
h-index: 0
机构:
Erasmus MC, Dept Clin Genet, Rotterdam, NetherlandsUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Bonifati, V.
Brooks, D.
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h-index: 0
机构:
Univ London Imperial Coll Sci Technol & Med, Hammersmith Hosp, Dept Clin Neurosci, London, EnglandUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Brooks, D.
Burn, D. J.
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Newcastle Univ, Inst Ageing & Hlth, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, EnglandUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Burn, D. J.
Colosimo, C.
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Univ Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, ItalyUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Colosimo, C.
Fanciulli, A.
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h-index: 0
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Med Univ Innsbruck, Dept Neurol, A-6020 Innsbruck, AustriaUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Fanciulli, A.
Ferreira, J.
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h-index: 0
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Fac Med Lisbon, Ctr Estudos Egas Moniz, Lisbon, PortugalUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Ferreira, J.
Gasser, T.
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h-index: 0
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Univ Tubingen, Dept Neurodegenerat Dis, Hertie Inst Clin Brain Res, German Ctr Neurodegenerat Dis, Tubingen, GermanyUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Gasser, T.
Grandas, F.
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h-index: 0
机构:
Hosp Univ Gregorio Maranon, Movement Disorders Res Unit, Madrid, SpainUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Grandas, F.
Kanovsky, P.
论文数: 0引用数: 0
h-index: 0
机构:
Palacky Univ, Dept Neurol, CR-77147 Olomouc, Czech RepublicUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Kanovsky, P.
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Kostic, V.
Kulisevsky, J.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Autonoma Barcelona, St Pau Hosp, Dept Neurol, Movement Disorders Unit, E-08193 Barcelona, Spain
Ciberned, Barcelona, SpainUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Kulisevsky, J.
Oertel, W.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Marburg, Dept Neurol, Ctr Nervous Dis, Marburg, GermanyUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Oertel, W.
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Poewe, W.
Reese, J. -P.
论文数: 0引用数: 0
h-index: 0
机构:Univ Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Reese, J. -P.
Relja, M.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Zagreb, Sch Med, Movement Disorders Ctr, Dept Neurol, Zagreb 41001, Croatia
Univ Zagreb, Univ Hosp Ctr, Zagreb 41000, CroatiaUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Relja, M.
Ruzicka, E.
论文数: 0引用数: 0
h-index: 0
机构:
Charles Univ Prague, Fac Med 1, Prague, Czech Republic
Charles Univ Prague, Gen Univ Hosp Prague, Prague, Czech RepublicUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Ruzicka, E.
Schrag, A.
论文数: 0引用数: 0
h-index: 0
机构:
UCL, Inst Neurol, London, EnglandUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Schrag, A.
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Seppi, K.
Taba, P.
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Univ Tartu, Dept Neurol & Neurosurg, EE-50090 Tartu, EstoniaUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Taba, P.
Vidailhet, M.
论文数: 0引用数: 0
h-index: 0
机构:
Hop La Pitie Salpetriere, Paris, France
Hop La Pitie Salpetriere, CRICM UPMC, INSERM UMR S975, CNRS UMR7225, Paris, FranceUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
机构:
Univ Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Univ Roma La Sapienza, IRCCS NEUROMED Inst, I-00185 Rome, ItalyUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Berardelli, A.
Wenning, G. K.
论文数: 0引用数: 0
h-index: 0
机构:
Med Univ Innsbruck, Dept Neurol, A-6020 Innsbruck, AustriaUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Wenning, G. K.
Antonini, A.
论文数: 0引用数: 0
h-index: 0
机构:
Parkinsons Dis & Movement Disorders Unit IRCCS, Milan, ItalyUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Antonini, A.
Berg, D.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Tubingen, Dept Neurodegenerat Dis, Hertie Inst Clin Brain Res, German Ctr Neurodegenerat Dis, Tubingen, Germany
DZNE, Tubingen, GermanyUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Berg, D.
Bloem, B. R.
论文数: 0引用数: 0
h-index: 0
机构:
Radboud Univ Nijmegen, Med Ctr, Dept Neurol, Donders Inst Brain Cognit & Behav, NL-6525 ED Nijmegen, NetherlandsUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Bloem, B. R.
Bonifati, V.
论文数: 0引用数: 0
h-index: 0
机构:
Erasmus MC, Dept Clin Genet, Rotterdam, NetherlandsUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Bonifati, V.
Brooks, D.
论文数: 0引用数: 0
h-index: 0
机构:
Univ London Imperial Coll Sci Technol & Med, Hammersmith Hosp, Dept Clin Neurosci, London, EnglandUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Brooks, D.
Burn, D. J.
论文数: 0引用数: 0
h-index: 0
机构:
Newcastle Univ, Inst Ageing & Hlth, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, EnglandUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Burn, D. J.
Colosimo, C.
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h-index: 0
机构:
Univ Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, ItalyUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Colosimo, C.
Fanciulli, A.
论文数: 0引用数: 0
h-index: 0
机构:
Med Univ Innsbruck, Dept Neurol, A-6020 Innsbruck, AustriaUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Fanciulli, A.
Ferreira, J.
论文数: 0引用数: 0
h-index: 0
机构:
Fac Med Lisbon, Ctr Estudos Egas Moniz, Lisbon, PortugalUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Ferreira, J.
Gasser, T.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Tubingen, Dept Neurodegenerat Dis, Hertie Inst Clin Brain Res, German Ctr Neurodegenerat Dis, Tubingen, GermanyUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Gasser, T.
Grandas, F.
论文数: 0引用数: 0
h-index: 0
机构:
Hosp Univ Gregorio Maranon, Movement Disorders Res Unit, Madrid, SpainUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Grandas, F.
Kanovsky, P.
论文数: 0引用数: 0
h-index: 0
机构:
Palacky Univ, Dept Neurol, CR-77147 Olomouc, Czech RepublicUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Kanovsky, P.
论文数: 引用数:
h-index:
机构:
Kostic, V.
Kulisevsky, J.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Autonoma Barcelona, St Pau Hosp, Dept Neurol, Movement Disorders Unit, E-08193 Barcelona, Spain
Ciberned, Barcelona, SpainUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Kulisevsky, J.
Oertel, W.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Marburg, Dept Neurol, Ctr Nervous Dis, Marburg, GermanyUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Oertel, W.
论文数: 引用数:
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机构:
Poewe, W.
Reese, J. -P.
论文数: 0引用数: 0
h-index: 0
机构:Univ Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Reese, J. -P.
Relja, M.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Zagreb, Sch Med, Movement Disorders Ctr, Dept Neurol, Zagreb 41001, Croatia
Univ Zagreb, Univ Hosp Ctr, Zagreb 41000, CroatiaUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Relja, M.
Ruzicka, E.
论文数: 0引用数: 0
h-index: 0
机构:
Charles Univ Prague, Fac Med 1, Prague, Czech Republic
Charles Univ Prague, Gen Univ Hosp Prague, Prague, Czech RepublicUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Ruzicka, E.
Schrag, A.
论文数: 0引用数: 0
h-index: 0
机构:
UCL, Inst Neurol, London, EnglandUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Schrag, A.
论文数: 引用数:
h-index:
机构:
Seppi, K.
Taba, P.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Tartu, Dept Neurol & Neurosurg, EE-50090 Tartu, EstoniaUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy
Taba, P.
Vidailhet, M.
论文数: 0引用数: 0
h-index: 0
机构:
Hop La Pitie Salpetriere, Paris, France
Hop La Pitie Salpetriere, CRICM UPMC, INSERM UMR S975, CNRS UMR7225, Paris, FranceUniv Roma La Sapienza, Dipartimento Neurol & Psichiatria, I-00185 Rome, Italy