Distinguishing Parkinson’s disease and essential tremor with transcranial sonography
Article first published online: 28 JUN 2008
Copyright © 2008 The Authors. Journal compilation © 2008 Blackwell Munksgaard
Acta Neurologica Scandinavica
Volume 119, Issue 1, pages 17–21, January 2009
How to Cite
Budisic, M., Trkanjec, Z., Bosnjak, J., Lovrencic-Huzjan, A., Vukovic, V. and Demarin, V. (2009), Distinguishing Parkinson’s disease and essential tremor with transcranial sonography. Acta Neurologica Scandinavica, 119: 17–21. doi: 10.1111/j.1600-0404.2008.01056.x
- Issue published online: 16 DEC 2008
- Article first published online: 28 JUN 2008
- Accepted for publication April 21, 2008
- brain parenchyma sonography;
- transcranial sonography;
- substantia nigra;
- essential tremor
Objectives – Until today there is no reliable test that can clearly distinguish Parkinson’s disease (PD) from the essential tremor (ET). Our aim was to determine the usefulness of the transcranial sonography (TCS) in the differential diagnosis of the PD and ET as well as the interobserver reliability for this method.
Methods – Transcranial sonography of substantia nigra and clinical examination were performed on 80 PD patients, 30 ET patients, and 80 matched controls by two independent physicians.
Results – Bilateral SN hyperechogenicity over the margin of 0.20 cm2 was found in 91% of PD patients, 10% of healthy subjects, and in 13% patients with ET. Interobserver agreement for this method was significant (Student’s t-test, P = 1.000).
Conclusions – Substantia nigra hyperechogenicity on TCS is a highly specific finding of PD, where in healthy individuals or in ET patients, it might correspond to an increased risk of developing PD later in life or might also be because of the impairment of nearby area of nucleus ruber in ET patients, as suggested by positron emission tomography studies. TCS may serve as a practical and sufficiently sensitive neuroimaging tool in PD diagnoses and in distinguishing it from ET; its repeatability and accuracy might add to its practical value.