title: Evaluation of transcranial sonographic findings and MIBG cardiac scintigraphy in the diagnosis of idiopathic Parkinson's disease.
abstract: The diagnosis of idiopathic Parkinson's disease (IPD) is based on clinical criteria. In the last two decades several neuroimaging methods using transcranial sonography (TCS) or radiolabelled tracers such as the myocardial MIBG scintigraphy were applied to support diagnosis of IPD. They have been used independently of each other and their interrelation is not yet clear. In the present study we analyzed the relation between findings of TCS, MIBG scintigraphy, and clinical presentation in 42 patients with IPD who were clinically diagnosed and underwent clinical follow-up over ≥3 years in order to confirm IPD diagnosis throughout the clinical course. The extent of substantia nigra hyperechogenicity (SN+) contralateral to the clinically more affected body side (SN(contra)) was compared to myocardial (123)I-MIBG uptake. SN(contra) did not correlate with the myocardial MIBG uptake (r = -0.10; p = 0.52). Both myocardial MIBG uptake and TCS did not correlate significantly with Hoehn and Yahr stage (r = -0.03; p = 0.87 and r = -0.10; p = 0.54, respectively). Sensitivity of TCS in the diagnosis of IPD was 79%, of MIBG scintigraphy 81%. The combination of both measurements reached a sensitivity of 95%. TCS and MIBG scintigraphy may disclose complementary aspects of IPD. The combined use of both neuroimaging methods might improve the diagnostic sensitivity regarding IPD.
authors.affiliation: Department of Neurology, Saarland University, Kirrberger Strasse, 66421 Homburg/Saar, Germany.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Behnke
authors.forename: Dirk
authors.initials: D
authors.lastname: Hellwig
authors.forename: Jan
authors.initials: J
authors.lastname: Bürmann
authors.forename: Anne
authors.initials: A
authors.lastname: Runkel
authors.forename: Georgios
authors.initials: G
authors.lastname: Farmakis
authors.forename: Carl M
authors.initials: CM
authors.lastname: Kirsch
authors.forename: Klaus
authors.initials: K
authors.lastname: Fassbender
authors.forename: Georg
authors.initials: G
authors.lastname: Becker
authors.forename: Ulrich
authors.initials: U
authors.lastname: Dillmann
authors.forename: Jörg
authors.initials: J
authors.lastname: Spiegel
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000592:standards*; D010300:Parkinson Disease / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D017585:Ultrasonography, Doppler, Transcranial / Q000592:standards*
keywords: MIBG scintigraphy; Parkinson's disease; Substantia nigra hyperechogenicity; Transcranial sonography