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Brain parenchyma sonography and 123 I‐FP‐CIT SPECT in Parkinson's disease and essential tremor
Author(s) -
Doepp Florian,
Plotkin Michail,
Siegel Lara,
Kivi Anatol,
Gruber Doreen,
Lobsien Elmar,
Kupsch Andreas,
Schreiber Stephan J.
Publication year - 2007
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.21861
Subject(s) - pathological , medicine , essential tremor , spect imaging , dopamine transporter , nuclear medicine , echogenicity , parkinson's disease , substantia nigra , central nervous system disease , pathology , radiology , disease , ultrasound , dopamine , dopaminergic , physical medicine and rehabilitation
We aimed to investigate the accuracy of transcranial brain parenchyma sonography (TCS) for differentiation between idiopathic Parkinson's disease (PD) and essential tremor (ET) in comparison to 123 I‐FP‐CIT SPECT (FP‐CIT SPECT). Seventy‐four patients, in whom PD or ET was suspected on the basis of clinical criteria, were analyzed. The echogenicity of the substantia nigra (SN) and the striatal binding of dopamine transporters (DAT) were evaluated by TCS and FP‐CIT SPECT, respectively. Three patients were excluded due to an insufficient transtemporal bone window using TCS. Forty‐six and 25 patients were clinically classified as PD and ET. SPECT revealed a reduced DAT binding in 42 of all 71 included patients. Thirty‐six of the 42 patients with abnormal FP‐CIT SPECT findings had a pathological SN hyperechogenicity, whereas TCS findings in the remaining 6 patients were normal. In 27 of 29 patients with normal SPECT findings the SN echogenicity was regular. Referring to FP‐CIT SPECT, the sensitivity and specificity of TCS for detection of PD were 86 and 93%; the positive and negative predictive values were 95 and 82%, respectively. Sensitivity and specificity in detection of clinically diagnosed PD patients were 78 and 92% for TCS and 91 and 100% for FP‐CIT SPECT, respectively. In patients with pathological FP‐CIT SPECT and pathological TCS, the extent of SN hyperechogenicity did not correlate with the degree of reduction in dopamine transporter binding on the side opposite of the more affected limb. TCS allows a reliable differentiation of PD and ET. The TCS SN hyperechogenicity does not correlate with the extent of dopaminergic neuron degeneration. © 2007 Movement Disorder Society