title: Transcranial brain sonography findings in two main variants of progressive supranuclear palsy.
abstract: OBJECTIVE
  Progressive supranuclear palsy (PSP) can occur with two main clinical presentations, classified as classical Richardson's syndrome (PSP-RS) and as PSP-parkinsonism (PSP-P), the most common atypical PSP variant. The differential diagnosis between them is challenging. Therefore, we studied different ultrasound markers by transcranial sonography in individuals with PSP-RS and PSP-P, to test their value in the diagnostic work up of these patients.
  
  
  METHODS
  Transcranial sonography was performed in 21 patients with PSP-RS and 11 patients with PSP-P. Echogenic sizes of the substantia nigra (SN) and the lenticular nuclei (LN), as well as the width of the third ventricle, were measured.
  
  
  RESULTS
  Among the patients with PSP-RS and PSP-P, three (14%) and eight (73%) patients had a hyperechogenic SN (P = 0.020), respectively. Uni- or bilateral hyperechogenicity of the LN was observed in 67% and 36% of patients with PSP-RS and PSP-P, respectively (P = 0.101). Third ventricle was significantly wider in patients with PSP-RS (11.2 ± 2.3 mm) when compared with patients with PSP-P (7.5 ± 1.4 mm; P = 0.001).
  
  
  CONCLUSIONS
  Our data, possibly reflecting pathological differences, primarily contribute supporting the view that the neurodegenerative process differs in the two PSP variants.
authors.affiliation: Department of Neurology, School of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: V S
authors.initials: VS
authors.lastname: Kostić
authors.affiliation: Department of Neurology, School of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: M
authors.initials: M
authors.lastname: Mijajlović
authors.affiliation: Neurology Clinic, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina.
authors.forename: D
authors.initials: D
authors.lastname: Smajlović
authors.affiliation: Department of Neurology, School of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: M J
authors.initials: MJ
authors.lastname: Lukić
authors.affiliation: Department of Neurology, School of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: A
authors.initials: A
authors.lastname: Tomić
authors.affiliation: Department of Neurology, School of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: M
authors.initials: M
authors.lastname: Svetel
mesh_terms: D000368:Aged; D001921:Brain / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013494:Supranuclear Palsy, Progressive / Q000000981:diagnostic imaging*; D017585:Ultrasonography, Doppler, Transcranial