title: Brain sonography insight into the midbrain in myotonic dystrophy type 2.
abstract: BACKGROUND
  The aim of this study was to analyze transcranial sonography (TCS) findings in genetically confirmed myotonic dystrophy type 2 (DM2) patients.
  
  
  METHODS
  Forty DM2 patients and 38 gender- and age-matched healthy controls (HCs) underwent TCS through the pre-auricular acoustic bone window.
  
  
  RESULTS
  Substantia nigra hyperechogenicity was found in 20% of DM2 patients compared with 3% of HCs. Brainstem raphe (BR) hypoechogenicity was more common in DM2 patients compared with HCs (56% vs. 10%, P < 0.01), and it was more common in patients with fatigue and excessive daytime sleepiness (P < 0.05). Diameter of the third ventricle was increased in DM2 patients compared with HCs (5.8 ± 1.7 vs. 5.1 ± 1.0 mm, P < 0.05).
  
  
  CONCLUSIONS
  Finding BR hypoechogenicity might have clinical implication because of the potential response to serotonin-reuptake inhibitors. TCS revealed alterations in brain structures previously not seen in MRI studies.
authors.affiliation: Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, 6, Dr Subotica Street, 11000, Belgrade, Serbia.
authors.forename: Vidosava
authors.initials: V
authors.lastname: Rakocevic-Stojanovic
authors.affiliation: Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, 6, Dr Subotica Street, 11000, Belgrade, Serbia.
authors.forename: Stojan
authors.initials: S
authors.lastname: Peric
authors.affiliation: Center for Human Molecular Genetics, Faculty of Biology, School of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Dusanka
authors.initials: D
authors.lastname: Savic-Pavicevic
authors.affiliation: Center for Human Molecular Genetics, Faculty of Biology, School of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Jovan
authors.initials: J
authors.lastname: Pesovic
authors.affiliation: Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, 6, Dr Subotica Street, 11000, Belgrade, Serbia.
authors.forename: Sarlota
authors.initials: S
authors.lastname: Mesaros
authors.affiliation: Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, 6, Dr Subotica Street, 11000, Belgrade, Serbia.
authors.forename: Dragana
authors.initials: D
authors.lastname: Lavrnic
authors.affiliation: Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, 6, Dr Subotica Street, 11000, Belgrade, Serbia.
authors.forename: Zagorka
authors.initials: Z
authors.lastname: Jovanovic
authors.affiliation: Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, 6, Dr Subotica Street, 11000, Belgrade, Serbia.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Pavlovic
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004453:Echoencephalography; D005221:Fatigue / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008636:Mesencephalon / Q000000981:diagnostic imaging; D008875:Middle Aged; D009223:Myotonic Dystrophy / Q000150:complications / Q000000981:diagnostic imaging*; D011903:Raphe Nuclei / Q000000981:diagnostic imaging*; D013378:Substantia Nigra / Q000000981:diagnostic imaging*; D020542:Third Ventricle / Q000000981:diagnostic imaging*
keywords: brainstem raphe; fatigue; myotonic dystrophy type 2; sleepiness; substantia nigra; transcranial sonography