Sonographic discrimination of corticobasal degeneration vs progressive supranuclear palsy.
OBJECTIVE
To study the use of brain parenchyma sonography (BPS) in discriminating between patients with corticobasal degeneration (CBD) and progressive supranuclear palsy (PSP).


METHODS
Thirteen patients with PSP and eight with CBD were studied with BPS according to a standardized protocol.


RESULTS
Seven (88%) of the eight CBD patients showed marked hyperechogenicity of the substantia nigra (SN) but none of eleven PSP patients (Mann-Whitney U test, p < 0.001). This finding indicated CBD with a positive predictive value of 100%. Marked dilatation of the third ventricle (width > 10 mm) was found in 10 (83%) of 12 PSP patients, but in none of the CBD patients (p < 0.005). BPS measurements of ventricle widths closely matched MRI measurements (Pearson correlation, r = 0.90, p < 0.001). The presence of at least one of the BPS findings 1) marked SN hyperechogenicity and 2) third-ventricle width < 10 mm indicated CBD with a sensitivity of 100%, a specificity of 83%, and a positive predictive value of 80%. Other BPS findings such as echogenicity of lentiform and caudate nuclei and widths of the frontal horns did not discriminate between CBD and PSP. One PSP patient could not be assessed because of insufficient acoustic temporal bone windows.


CONCLUSIONS
Substantia nigra hyperechogenicity, reported earlier as characteristic brain parenchyma sonography finding in idiopathic Parkinson disease, is also typical for corticobasal degeneration.
Department of Neurology, University of Rostock, Gehlsheimer Str. 20, D-18147 Rostock, Germany. uwe.walter@med.uni-rostock.de
U
U
Walter
D
D
Dressler
A
A
Wolters
T
T
Probst
A
A
Grossmann
R
R
Benecke
D000368:Aged; D000369:Aged, 80 and over; D001933:Brain Stem / Q000000981:diagnostic imaging / Q000473:pathology; D002421:Caudate Nucleus / Q000000981:diagnostic imaging / Q000473:pathology; D002552:Cerebral Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D014695:Cerebral Ventriculography; D003072:Cognition Disorders / Q000209:etiology; D003342:Corpus Striatum / Q000000981:diagnostic imaging / Q000473:pathology; D003937:Diagnosis, Differential; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000523:psychology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016037:Single-Blind Method; D013378:Substantia Nigra / Q000000981:diagnostic imaging* / Q000473:pathology; D013494:Supranuclear Palsy, Progressive / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000523:psychology; D024801:Tauopathies / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology / Q000523:psychology; D013788:Thalamus / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography