Specificity of transcranial sonography in parkinson spectrum disorders in comparison to degenerative cognitive syndromesReport as inadecuate




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BMC Neurology

, 12:12

First Online: 08 March 2012Received: 31 August 2011Accepted: 08 March 2012

Abstract

BackgroundHyperechogenicity of the substantia nigra SN+, detected by transcranial sonography TCS, was reported as a characteristic finding in Parkinson-s disease PD, with high diagnostic accuracy values, when compared mainly to healthy controls or essential tremor ET group. However, some data is accumulating that the SN + could be detected in other neurodegenerative and even in non-neurodegenerative disorders too. Our aim was to estimate the diagnostic accuracy of TCS, mainly focusing on the specificity point, when applied to a range of the parkinsonian disorders, and comparing to the degenerative cognitive syndromes.

MethodsA prospective study was carried out at the Hospital of Lithuanian University of Health Sciences from January until September 2011. Initially, a TCS and clinical examination were performed on 258 patients and 76 controls. The General Electric Voluson 730 Expert ultrasound system was used. There were 12.8% of cases excluded with insufficient temporal bones, and 4.3% excluded with an unclear diagnosis. The studied sample consisted of the groups: PD n = 71, 33.2%, ET n = 58, 27.1%, PD and ET n = 10, 4.7%, atypical parkinsonian syndromes APS n = 3, 1.4%, hereditary neurodegenerative parkinsonism HDP n = 3, 1.4%, secondary parkinsonism SP n = 23, 10.8%, mild cognitive impairment MCI n = 33, 15.4%, dementia n = 13, 6.1%, and control n = 71.

ResultsThere were 80.3% of PD patients at stages 1 and 2 according to Hoehn and Yahr. At the cut-off value of 0.20 cm of the SN+, the sensitivity for PD was 94.3% and the specificity - 63.3% ROC analysis, AUC 0.891, in comparison to the rest of the cohort. At the cut-off value of 0.26 cm, the sensitivity was 90% and the specificity 82.4%.

The estimations for the lowest specificity for PD, in comparison to the latter subgroups at the cut-off values of 0.20 cm and 0.26 cm, respectively were: 0% and 33.3% to APS, 33.3% and 66.7% to HDP, 34.8% and 69.6% to SP, 55.2% and 82.8% to ET, 75% and 91.7% to dementia.

ConclusionsThe high sensitivity of the test could be employed as a valuable screening tool. But TCS is more useful as a supplementary diagnostic method, due to the specificity values not being comprehensive.

KeywordsTranscranial sonography Substantia nigra Parkinson-s disease Cognitive disorders Specificity Sensitivity Electronic supplementary materialThe online version of this article doi:10.1186-1471-2377-12-12 contains supplementary material, which is available to authorized users.

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Author: Kristina Laučkaitė - Daiva Rastenytė - Danguolė Šurkienė - Antanas Vaitkus - Andrius Sakalauskas - Arūnas Lukoševič

Source: https://link.springer.com/







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